玻璃体腔注射雷珠单抗治疗视网膜血管瘤样增生疗效观察  

Intravitreal injection of ranibizumab for retinal angiomatous proliferation

作　　者：王怀华[1] 王敏[1] 徐楠楠[1] 石德鹏 徐海峰[1] 

机构地区：[1]山东省眼科研究所青岛眼科医院,266071

出　　处：《中华眼底病杂志》2014年第5期466-469,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的 观察玻璃体腔注射雷珠单抗（IVR）治疗视网膜血管瘤样增生（RAP）的临床效果.方法 回顾性分析临床确诊为RAP并行IVR治疗的11例患者14只眼的临床资料.所有患眼均行最佳矫正视力（BCVA）检查,并采用光相干断层扫描（OCT）检查测量中心凹视网膜厚度（CRT）、病变最厚处视网膜厚度（MRT）.患眼平均BCVA为（0.17±0.21）,平均CRT为（382.71±219.07）μm,平均MRT为（746.36±268.29） 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0.05ml（含雷珠单抗0.5 mg）.治疗后每一个月随访,平均随访时间（15.38±13.64）个月.随访期间OCT检查显示有视网膜水肿者再次给予IVR治疗.总注射次数1～10次,平均注射次数（3.54±3.26）次.以末次随访为疗效判定时间点,对比分析治疗前后患眼BCVA、CRT及MRT变化情况.同时观察其局部和全身不良反应的发生情况.结果 患眼BCVA为0.01～1.0,平均BCVA为0.28±0.26.14只眼中,视力提高11只眼,视力稳定2只眼,视力下降1只眼.治疗前后BCVA比较,差异有统计学意义（t=3.167,P=0.007）.OCT检查发现,患眼平均CRT为（166.14±52.79）μm,较治疗前明显降低.治疗前后CRT比较,差异有统计学意义（t=3.737,P=0.002）.患眼平均MRT为（360.43±102.19）μm,较治疗前明显降低.治疗前后MRT比较,差异有统计学意义（t=6.106,P=0.000）.所有患者在随访期内均未出现眼前节反应、眼压升高、眼内炎症、玻璃体积血及视网膜脱离等眼部不良反应,亦无心脑血管意外等全身疾病发生.结论 IVR能安全、有效地治疗RAP,提高患者视力,降低CRT及MRT.Objective To observe the efficacy of intravitreal injection of ranibizumab （IVR） for retinal angiomatous proliferation （RAP）.Methods Eleven patients （14 eyes） with RAP were enrolled in this retrospective clinical study.The best-corrected visual acuity （BCVA）,central retinal thickness （CRT）,and maximum retinal thickness （MRT） were detected by examination of visual acuity and optical coherence tomography （OCT）.The average BCVA was 0.17±0.21,CRT was （382.71 ±219.07） μm,MRT was （746.36±268.29） μm.All eyes received 0.5 mg （0.05 ml） ranibizumab injection.Follow-up visits were performed monthly after injection.The mean follow-up time was （15.38 ±13.64） month.Injections were repeated if the eyes with retinal edema.The mean number of repetitive IVR was （3.7 ±1.0） times/eye （from 1 to 10 times）.Changes in BCVA,CRT,MRT and complications were observed at the last follow up.Results At the last follow-up,the mean BCVA was 0.28±0.26 （from 0.01 to 1.0）.Of 14 eyes,visual acuity improved in 11 eyes,not changed in 2 eyes and decreased in 1 eye.The difference of BCVA was significant between before and after the treatment （t =3.167,P =0.007）.The mean CRT was （166.14 ±52.79） μm,which was less than that of pre-treatment values （t=3.737,P=0.002）.The mean MRT was （360.43±102.19） μm,which was less than that of pre-treatment values （t=6.106,P=0.000）.No ocular or systemic adverse effects occurred.Conclusion IVR is an efficient and safe treatment for RAP,with visual acuity improvement,decrease of CRT and MRT.

关 键 词：视网膜疾病/药物疗法 血管生成抑制剂/治疗应用 抗体 单克隆/治疗应用 

分 类 号：R774.1[医药卫生—眼科]