雷珠单抗治疗湿性年龄相关性黄斑变性疗效观察  

Efficacy of ranibizumab for the treatment ofwet age-related macular degeneration （AMD）

作　　者：白蓉 哈少平 盛迅伦 李静 范文燕 

机构地区：[1]宁夏人民医院宁夏眼科医院,银川750011

出　　处：《中国实用眼科杂志》2015年第2期146-150,共5页Chinese Journal of Practical Ophthalmology

基　　金：国家重点基础研究发展计划

摘　　要：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0．5mg，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）灿m。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〈O．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4．54mm2。治疗后2例2只跟出现结膜下出血，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。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 （BC- VA）, intraocular pressure （IOP）, optic coherence tomography （OCT）, indocyaninegeen angiography（IC- GA）, 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 maeula） 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 vanish- ing with a mean decrease of 4.54mm2 compared with pre-treatment. Two patients had subconjuncti- val 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.

关 键 词：雷珠单抗 湿性年龄相关性黄斑变性 抗-VEGF 

分 类 号：R774.5[医药卫生—眼科]