Lucentis治疗黄斑脉络膜新生血管1年的临床疗效观察  

Clinical effects of Lucentis in treatment of macular choroid neovascularization for 1 year

作　　者：郑燕林[1] 彭晓丽 陈廷[3] 郑淼[3] 智亚伟 耿艳[3] 

机构地区：[1]成都中医药大学附属医院眼科,四川省成都市610072 [2]运城市眼科医院,山西省运城市044000 [3]成都中医药大学,四川省成都市610072

出　　处：《眼科新进展》2016年第4期348-351,共4页Recent Advances in Ophthalmology

摘　　要：目的采用1＋PRN的方案治疗年龄相关性黄斑变性（age-related macular degeneration,AMD）及高度近视黄斑脉络膜新生血管（choroidal neovascularization,CNV）,观察其1 a疗效。方法收集2012年7月至2014年4月在我院眼科就诊,确诊为黄斑区CNV（继发于AMD或高度近视者）并接受单一的玻璃体内注射Lucentis（单次剂量0.5 mg/0.05 m L）的73例（79眼;其中AMD患者38眼,高度近视黄斑CNV患者41眼）患者的临床资料。记录治疗后1 d、1周及1 a内每月的最佳矫正视力（best corrected visual a-cuity,BCVA）、黄斑中心视网膜厚度（central retina thickness,CRT）以及1 a后地图状萎缩进展情况。结果治疗后不同时间点AMD与高度近视患者的平均BCVA均较治疗前提高,差异均有统计学意义（均为P〈0.05）,其中治疗后1周~3个月提高幅度最明显,治疗后3个月~1 a基本保持平稳。CRT变化情况与BCVA一致。1 a观察终点时,所有患者中治疗眼与非治疗眼地图状萎缩的发展并无明显差异。随访期内,10眼结膜下出血,1眼虹膜色素脱失,1眼轻度视网膜劈裂,未发现眼压升高、视网膜脱离、眼内炎等其他局部并发症及全身不良反应。结论采用1＋PRN治疗方案治疗AMD与高度近视黄斑CNV在1 a期间是安全有效的,注射次数较少的情况下对患者地图状萎缩进展影响不大。Objective To observe the clinical effects of intravitreal injection of ranibizumab in treatment of macular choroid neovascularization（ CNV） secondary to age-related macular degeneration（ AMD） and high myopia（ HM） for 1 year using an on-demand regimen（ 1＋ PRN）. Methods Seventy-nine eyes of 73 patients（ 38 eyes of AMD patients and 41 eyes of HM macular CNV patients） with CNV were collected from July 2012 to April 2014 in our hospital. All affected eye were treated only with intravitreal injection of ranibizumab（ single dose 0. 5 mg /0. 05 mL）. Follow-up time was 1 day,1 week and monthly for 1 year. Best corrected visual acuity（ BCVA）,macular retinal thickness（ CRT） were assessed at each follow-up time. Auto-fluorescence（ AF） was used before the first injection and 1 year after the first injection to assesse the progress of the geographic atrophy（ GA）. Results BCVA of all eyes were obviously increased at postoperative different time,there were statistical differences compared with pre-operation（ all P 0. 05）,in which BCVA was increased more obviously from 1 week to 3 months,and remained stable from 3 months to 1 year. CRT change was consistent with BCVA. There was no significant difference about GA after 1 year between the affected eye and non-affected eye. In the follow-up time,the intraocular pressure did not increase in all patients,but there were 10 eyes with subconjunctival hemorrhage,1 eye with ris depigmentation,1 eye with slightly retinoschisis,and no retinal detachment,endophthalmitis and other topical adverse events was observed. No serious systemic was observed. Conclusion Using 1 ＋ PRN therapy in the treatment of CNV secondary to AMD and HM macular CNV is safe and effective during the period of 1 year,and the few injections have little effects on the progress of GA.

关 键 词：雷珠单抗 年龄相关性黄斑变性 高度近视黄斑病变 

分 类 号：R774.5[医药卫生—眼科]