CAJ | 학술논문

目的观察玻璃体腔注射雷珠单抗(IVR)治疗渗出型老年性黄斑变性(AMD)伴浆液性视网膜色素上皮脱离(PED)的临床效果.方法临床确诊为渗出型AMD伴浆液性PED并行IVR治疗的23例患者23只眼纳入研究.所有患者采用国际标准对数视力表行最佳矫正视力(BCVA)检查,检测结果转换为最小分辨角对数(logMAR)记录;并采用光相干断层扫描(OCT)检查测量PED高度、PED容积及黄斑中心凹视网膜厚度(CFT).患眼平均logMAR BCVA为0.77±0.39,平均PED高度为(357.2±171.9) μm,平均PED容积为(0.741±1.012) mm3,平均CFT为(317.9±73.8)μm.治疗方法为手术室无菌条件下常规玻璃体腔注射10 mg/ml的雷珠单抗0.05 ml(含雷珠单抗0.5 mg),每一个月注射1次,连续注射3次,此后根据随访情况按需注射.以末次治疗后6个月为疗效判定时间点,对比分析治疗前后患眼BCVA、PED高度、PED容积及CFT变化情况.结果治疗后患眼平均logMAR BCVA为0.61±0.27,较治疗前明显提高,差异有统计学意义(t=2.601,P＜0.05).23只眼中,视力提高17只眼,视力稳定4只眼,视力下降2只眼.治疗后患眼平均PED高度为(247.7±171.7)μm,平均PED容积为(0.337±0.498) mm3,平均CFT为(302.5±89.3) μm.与治疗前比较,治疗后患眼平均PED高度、平均PED容积均明显减小,差异有统计学意义(t=3.192、2.502,P＜0.05);平均CFT有所降低,但差异无统计学意义(t=0.887,P＞0.05).所有患者在随访期内均未发生眼内炎、葡萄膜炎等眼部不良反应.结论 IVR能安全有效地治疗伴有浆液性PED的渗出型AMD,提高患者视力,降低PED高度,减小PED容积.
목적 관찰파리체강주사뢰주단항(IVR)치료삼출형노년성황반변성(AMD)반장액성시망막색소상피탈리(PED)적림상효과.방법 림상학진위삼출형AMD반장액성PED병행IVR치료적23례환자23지안납입연구.소유환자채용국제표준대수시력표행최가교정시력(BCVA)검사,검측결과전환위최소분변각대수(logMAR)기록;병채용광상간단층소묘(OCT)검사측량PED고도、PED용적급황반중심요시망막후도(CFT).환안평균logMAR BCVA위0.77±0.39,평균PED고도위(357.2±171.9) μm,평균PED용적위(0.741±1.012) mm3,평균CFT위(317.9±73.8)μm.치료방법위수술실무균조건하상규파리체강주사10 mg/ml적뢰주단항0.05 ml(함뢰주단항0.5 mg),매일개월주사1차,련속주사3차,차후근거수방정황안수주사.이말차치료후6개월위료효판정시간점,대비분석치료전후환안BCVA、PED고도、PED용적급CFT변화정황.결과 치료후환안평균logMAR BCVA위0.61±0.27,교치료전명현제고,차이유통계학의의(t=2.601,P＜0.05).23지안중,시력제고17지안,시력은정4지안,시력하강2지안.치료후환안평균PED고도위(247.7±171.7)μm,평균PED용적위(0.337±0.498) mm3,평균CFT위(302.5±89.3) μm.여치료전비교,치료후환안평균PED고도、평균PED용적균명현감소,차이유통계학의의(t=3.192、2.502,P＜0.05);평균CFT유소강저,단차이무통계학의의(t=0.887,P＞0.05).소유환자재수방기내균미발생안내염、포도막염등안부불량반응.결론 IVR능안전유효지치료반유장액성PED적삼출형AMD,제고환자시력,강저PED고도,감소PED용적.
Objective To evaluate the effects of intravitreal ranibizumab therapy for serous pigment epithelial detachment (sPED) secondary to exudative age-related macular degeneration(eAMD).Methods Twenty-three eyes from 23 patients of eAMD with sPED were enrolled in this study.The best corrected visual acuity,ocular coherence tomography (OCT),maximum PED height from baseline,volume of PED and central fovea thickness(CFT)were collected monthly for these patients.And the patients were receiced intravitreal injection with ranibizumab of 0.5 mg of three consecutive monthly injections.Results No complications were observed during the study period.After 6 months follow-up,17 eyes improved,4 eyes unchanged and only 2 eye decreased.The best corrected visual acuity was from 0.77 ± 0.39 up to 0.61± 0.27(t=2.601,P＜0.05).It was observed by OCT that the PED height was decreased from (357.2± 171.9) μm (before treatment) to (247.7 ± 171.7) μm (after treatment) (t=3.192,P＜0.05) and the volume of PED was decreased from(0.741 ± 1.012) mm3 to (0.337 ± 0.498) mm3 (t =2.502,P＜0.05).The central foveal thickness was decreased from (317.9 ± 73.8) μm to (302.5 ± 89.3)μm,but the difference were no statistically significantly (t =0.887,P＞ 0.05).Conclusion Ranibizumab may be an effective treatment for improving vision and reducing the degree of PED in eAMD patients.