中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2015年
3期
256-259
,共4页
余岚%陈长征%易佐慧子%苏钰%周芸芸%郑红梅%戚沆
餘嵐%陳長徵%易佐慧子%囌鈺%週蕓蕓%鄭紅梅%慼沆
여람%진장정%역좌혜자%소옥%주예예%정홍매%척항
脉络膜新生血管化/药物疗法%湿性黄斑变性/药物疗法%血管生成抑制剂/治疗应用%抗体,单克隆/治疗应用
脈絡膜新生血管化/藥物療法%濕性黃斑變性/藥物療法%血管生成抑製劑/治療應用%抗體,單剋隆/治療應用
맥락막신생혈관화/약물요법%습성황반변성/약물요법%혈관생성억제제/치료응용%항체,단극륭/치료응용
Choroidal neovascularization/drug therapy%Wet macular degeneration/drug therapy%Angiogenesis inhibitors/therapeutic use%Antibodies,monoclonal/therapeutic use
目的 观察玻璃体腔注射康柏西普治疗渗出型老年性黄斑变性(AMD)的有效性及安全性.方法 前瞻性、无对照、开放性研究.经荧光素眼底血管造影(FFA)和吲哚青绿血管造影(ICGA)检查确诊为渗出型AMD的20例患者20只眼纳入本研究.所有患眼均可见黄斑区脉络膜新生血管(CNV)渗漏病灶.采用糖尿病视网膜病变早期治疗研究视力表检查最佳矫正视力(BCVA),光相干断层扫描(OCT)检查测量中心视网膜厚度(CRT).患眼平均BCVA为(41.20±22.61)个字母,平均CRT为(345.25±131.96)μm.所有患眼玻璃体腔注射10 mg/ml的康柏西普0.05 ml(含康柏西普0.5 mg),每一个月注射1次,连续3次为初始治疗,后根据病情需要决定是否重复治疗.患眼平均注射次数(3.45±0.69)次.每一个月随访1次,平均随访时间(7.35±0.99)个月.对比分析治疗前后患眼BCVA、CRT及CNV病灶渗漏的变化,同时观察随访期间眼部与全身不良反应的发生情况.结果 治疗后1、3、6个月及末次随访时,患眼平均BCVA均较治疗前提高,差异均有统计学意义(t=5.85、7.09、7.44、7.25,P<0.01).治疗后1个月,视力显著提高6只眼,占30%;提高8只眼,占40%;稳定6只眼,占30%;末次随访时,视力显著提高6只眼,占30%;提高9只眼,占45%;稳定5只眼,占25%.治疗后1、3、6个月及末次随访时,患眼平均CRT均较治疗前降低,差异也有统计学意义(t=3.34、3.78、3.47、3.44,P<0.05).末次随访时,FFA、ICGA检查发现,黄斑区CNV病灶渗漏消失6只眼,占30%;渗漏减轻11只眼,占55%;渗漏扩大3只眼,占15%.随访期间均未见视网膜脱离、视网膜撕裂、眼压持续升高、眼内炎等与治疗相关的严重眼部并发症,亦未见全身严重不良反应发生.结论 玻璃体腔注射康柏西普治疗渗出型AMD可提高患眼视力,降低患眼CRT;无与治疗相关的不良反应发生.
目的 觀察玻璃體腔註射康柏西普治療滲齣型老年性黃斑變性(AMD)的有效性及安全性.方法 前瞻性、無對照、開放性研究.經熒光素眼底血管造影(FFA)和吲哚青綠血管造影(ICGA)檢查確診為滲齣型AMD的20例患者20隻眼納入本研究.所有患眼均可見黃斑區脈絡膜新生血管(CNV)滲漏病竈.採用糖尿病視網膜病變早期治療研究視力錶檢查最佳矯正視力(BCVA),光相榦斷層掃描(OCT)檢查測量中心視網膜厚度(CRT).患眼平均BCVA為(41.20±22.61)箇字母,平均CRT為(345.25±131.96)μm.所有患眼玻璃體腔註射10 mg/ml的康柏西普0.05 ml(含康柏西普0.5 mg),每一箇月註射1次,連續3次為初始治療,後根據病情需要決定是否重複治療.患眼平均註射次數(3.45±0.69)次.每一箇月隨訪1次,平均隨訪時間(7.35±0.99)箇月.對比分析治療前後患眼BCVA、CRT及CNV病竈滲漏的變化,同時觀察隨訪期間眼部與全身不良反應的髮生情況.結果 治療後1、3、6箇月及末次隨訪時,患眼平均BCVA均較治療前提高,差異均有統計學意義(t=5.85、7.09、7.44、7.25,P<0.01).治療後1箇月,視力顯著提高6隻眼,佔30%;提高8隻眼,佔40%;穩定6隻眼,佔30%;末次隨訪時,視力顯著提高6隻眼,佔30%;提高9隻眼,佔45%;穩定5隻眼,佔25%.治療後1、3、6箇月及末次隨訪時,患眼平均CRT均較治療前降低,差異也有統計學意義(t=3.34、3.78、3.47、3.44,P<0.05).末次隨訪時,FFA、ICGA檢查髮現,黃斑區CNV病竈滲漏消失6隻眼,佔30%;滲漏減輕11隻眼,佔55%;滲漏擴大3隻眼,佔15%.隨訪期間均未見視網膜脫離、視網膜撕裂、眼壓持續升高、眼內炎等與治療相關的嚴重眼部併髮癥,亦未見全身嚴重不良反應髮生.結論 玻璃體腔註射康柏西普治療滲齣型AMD可提高患眼視力,降低患眼CRT;無與治療相關的不良反應髮生.
목적 관찰파리체강주사강백서보치료삼출형노년성황반변성(AMD)적유효성급안전성.방법 전첨성、무대조、개방성연구.경형광소안저혈관조영(FFA)화신타청록혈관조영(ICGA)검사학진위삼출형AMD적20례환자20지안납입본연구.소유환안균가견황반구맥락막신생혈관(CNV)삼루병조.채용당뇨병시망막병변조기치료연구시력표검사최가교정시력(BCVA),광상간단층소묘(OCT)검사측량중심시망막후도(CRT).환안평균BCVA위(41.20±22.61)개자모,평균CRT위(345.25±131.96)μm.소유환안파리체강주사10 mg/ml적강백서보0.05 ml(함강백서보0.5 mg),매일개월주사1차,련속3차위초시치료,후근거병정수요결정시부중복치료.환안평균주사차수(3.45±0.69)차.매일개월수방1차,평균수방시간(7.35±0.99)개월.대비분석치료전후환안BCVA、CRT급CNV병조삼루적변화,동시관찰수방기간안부여전신불량반응적발생정황.결과 치료후1、3、6개월급말차수방시,환안평균BCVA균교치료전제고,차이균유통계학의의(t=5.85、7.09、7.44、7.25,P<0.01).치료후1개월,시력현저제고6지안,점30%;제고8지안,점40%;은정6지안,점30%;말차수방시,시력현저제고6지안,점30%;제고9지안,점45%;은정5지안,점25%.치료후1、3、6개월급말차수방시,환안평균CRT균교치료전강저,차이야유통계학의의(t=3.34、3.78、3.47、3.44,P<0.05).말차수방시,FFA、ICGA검사발현,황반구CNV병조삼루소실6지안,점30%;삼루감경11지안,점55%;삼루확대3지안,점15%.수방기간균미견시망막탈리、시망막시렬、안압지속승고、안내염등여치료상관적엄중안부병발증,역미견전신엄중불량반응발생.결론 파리체강주사강백서보치료삼출형AMD가제고환안시력,강저환안CRT;무여치료상관적불량반응발생.
Objective To observe the clinical efficiency of intravitreal Conbercept on exudative agerelated macular degeneration (eAMD).Methods This is an open and prospective study without control trial.Twenty eyes from 20 patients (19 males and 1 female) with eAMD diagnosed by fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study.Before the injection,best-corrected visual acuity (BCVA) of early treatment of diabetic retinopathy study (ETDRS),non-contact tonometer,ophthalmoscope,fundus photography,fundus fluorescein angiograph (FFA),indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were examined.The initial average letters of ETDRS acuity were 41.20±22.61,range from 8 to 80.The initial average central retina thickness (CRT) was (345.25± 131.96) μm,range from 152 to 770 μm.All affected eyes were treated with intravitreal conbercept 0.05 ml (10 mg/ml).The patients were followed up for 6 to 9 months,with the mean time of (7.35±0.99) months.The BCVA,CRT after treatment were compared with baseline using paired t-test.Results During the 1,3,6,12 months after treatment and the latest follow up,the mean BCVA were all improved with statistically significant difference (t=5.85,7.09,7.44,7.25; P< 0.05).At 1 month ater treatment,the mean BCVA was obviously improved in 6 eyes (30%),improved in 8 eyes (40%),stable in 6 eyes (30%).At latest follow up,the mean BCVA was obviously improved in 6 eyes (30%),improved in 9 eyes (45%),stable in 5 eyes (25%).During the 1,3,6,12 months after treatment and the latest follow up,the mean CRT were all decreased with statistically significant difference (t=3.34,3.78,3.47,3.44; P<0.05).At latest follow up,the leakage in macula lutea disappeared in 6 eyes (30%),decreased in 11 eyes (55%) and increased in 3 eyes (15%).No adverse events such as secondary retinal detachment or endoophthalmitis were found during the follow-up duration.Conclusion Intravitreal conbercept is a safe and effective approach for eAMD,may improve visual acuity,exudation and macular edema.