CAJ | 학술논문

目的观察玻璃体腔内注射雷珠单抗(Ranibizumab)治疗湿性年龄相关性黄斑变性(wAMD)的临床疗效.方法对2012年11月至2014年2月在宁夏眼科医院就诊的年龄＞60岁确诊为wAMD的患者38例41只眼,每月1次玻璃体腔内注射雷珠单抗0.5 mg,连续3次,之后按需注射.随访记录患者治疗前、治疗后1、3、6及12个月最佳矫正视力、眼压、光学相干断层成像、吲哚青绿脉络膜血管造影、多焦-ERG的数据资料,评估雷珠单抗治疗wAMD的临床疗效.结果 38例41只眼经玻璃体腔注射雷珠单抗治疗后12个月的最佳矫正视力与治疗前相比平均提高(14.98± 1.65)个字母.OCT测量视网膜黄斑中央厚度与治疗前相比平均下降了(123.98±24.09) μm.mf-ERG治疗前与治疗后6个月、12个月比较第1环(黄斑中心凹)及第2、3环(离心2.58°、5.71°)潜伏期缩短,振幅增大,差异有统计学意义(P＜0.05).治疗后吲哚青绿脉络膜血管造影荧光渗漏均有不同程度的减弱或消退,与治疗前相比渗漏面积平均下降了4.54 mm2.治疗后2例2只眼出现结膜下出血,5例5只眼出现角膜上皮损伤,3例3只眼出现眼压升高,1周后复查均恢复正常.结论运用雷珠单抗治疗wAMD可有效地减轻黄斑水肿,改善患者视力,不良反应少.
목적 관찰파리체강내주사뢰주단항(Ranibizumab)치료습성년령상관성황반변성(wAMD)적림상료효.방법 대2012년11월지2014년2월재저하안과의원취진적년령＞60세학진위wAMD적환자38례41지안,매월1차파리체강내주사뢰주단항0.5 mg,련속3차,지후안수주사.수방기록환자치료전、치료후1、3、6급12개월최가교정시력、안압、광학상간단층성상、신타청록맥락막혈관조영、다초-ERG적수거자료,평고뢰주단항치료wAMD적림상료효.결과 38례41지안경파리체강주사뢰주단항치료후12개월적최가교정시력여치료전상비평균제고(14.98± 1.65)개자모.OCT측량시망막황반중앙후도여치료전상비평균하강료(123.98±24.09) μm.mf-ERG치료전여치료후6개월、12개월비교제1배(황반중심요)급제2、3배(리심2.58°、5.71°)잠복기축단,진폭증대,차이유통계학의의(P＜0.05).치료후신타청록맥락막혈관조영형광삼루균유불동정도적감약혹소퇴,여치료전상비삼루면적평균하강료4.54 mm2.치료후2례2지안출현결막하출혈,5례5지안출현각막상피손상,3례3지안출현안압승고,1주후복사균회복정상.결론 운용뢰주단항치료wAMD가유효지감경황반수종,개선환자시력,불량반응소.
Objective To evaluate efficacy of ranibizumab for the treatment of wet age-related macular degeneration (wAMD).Methods Thirty-eight patients (41 eyes) with wAMD,older than 60 years,were enrolled to receive intravitreal injections of ranibizumab (0.5 mg) on 3 consecutive monthly schedule and then as needed with monthly evaluation.The best corrected visual acuity (BCVA),intraocular pressure (IOP),optic coherence tomography (OCT),indocyaninegeen angiography(ICGA),and multifocal ERG (mf-ERG) were measured before and 1 month,3,6,and 12 months after treatment.Results Mean BCVA gained 14.98±1.65 letters at 12 months after the treatment.The mean central retinal thickness (CRT) decreased 123.98±24.09μm.In mf-ERG examination,latency periods of the first ring (central fovea of macula) and the second and third ring (away from the center of 2.58°,5.71°) were shortened,and the mean amplitudes increased,at 6 and 12 months after treatment,which were statistically significant (P ＜0.05).The leakage areas inICGA showed weakening or vanishing with a mean decrease of 4.54mm2 compared with pre-treatment.Two patients had subconjunctival hemorrhage,5 corneal epithelial abrasion,3 intraocular pressure increased and they all recovered at one week after treatment.Conclusions Intravitreal administration of ranibizumab for the treatment in patients with wAMD is effective to alleviate macular edema and improve visual acuity with low rates of serious adverse events.