多焦视网膜电图对玻璃体腔注射雷珠单抗治疗湿性老年性黄斑变性的疗效评价  

Multifocal electroretinography for therapeutic effect evaluation of intravitreal injection Lucentis for wet age-related macular degeneration

作　　者：莒瑞红[1] 何曼莎 侯金佟[1] 李梦媛[1] 张静琳[1] 武哲明 

机构地区：[1]爱尔眼科医院集团广州爱尔眼科医院,广东广州510000

出　　处：《南方医科大学学报》2017年第7期933-937,共5页Journal of Southern Medical University

基　　金：广州市医药卫生科技项目(20141A011100)

摘　　要：目的应用多焦视网膜电图(mfERG)评价经玻璃体腔注射雷珠单抗治疗湿性老年性黄斑变性(AMD)前后视网膜功能的变化情况。方法前瞻性研究。共纳入2014年10月~2016年1月在广州爱尔眼科医院诊治的湿性老年性黄斑变性患者14例14只眼。所有患者接受玻璃体腔注射雷珠单抗治疗。本研究采用1+PRN的治疗方案。注射后每月复诊,根据复诊情况决定是否重复治疗。治疗前及首次治疗后l、3、6个月,记录最佳矫正视力、mfERG各环的潜伏期和振幅密度变化情况。结果末次随访时,患者平均接受雷珠单抗注射2.86±1.58次。治疗后1个月最佳矫正视力与术前相比无明显差异(P=0.07),治疗后3个月、6个月的视力与治疗前视力相比较,逐渐提高,且差异均有统计学意义(P<0.05)。与治疗前相比,治疗后6个环的潜伏期均无明显下降。治疗后1个月、3个月、6个月,1环及2环的N1波、Pl波振幅密度的升高较治疗前均有明显的统计学差异(P<0.05)。结论mfERG可以作为一种评价经玻璃体腔注射雷珠单抗治疗湿性AMD后患者视功能变化情况的良好指标。Objective To evaluate the changes in retinal functions usingmultifocal electroretinography （mfERG） followingintravitreal injection of Lucentis for treatment of wet age-related macular degeneration. Methods This prospective study wasconducted in 14 patients （9 men and 5 women, 14 eyes） with wet age-related macular degeneration receiving treatment withintravitreal injections of ranibizumab （Lucentis） in our hospital between October, 2014 and January, 2016. All the patientsreceived the treatment following a 1＋PRN protocol and after the initial injection, the patients were followed up monthly for 6months to decide if additional injections were needed. The corrected visual acuity and mfERG findings of the patients wereassessed before and at l, 3 and 6 months after the initial injection. Results At the last follow-up, the patients received injections for a mean of 2.86 ＆#177; 1.58 times. The best corrected visual acuity （BCVA） at 1 month after the initial treatment was not significantly different from that before treatment （P=0.07）, but showed significant improvements at 3 and 6 months （P〈0.05）. In mfERG, the implicit time of the 6 rings showed no significant decrease after the treatment, but the amplitude density of P1 andN1 in rings 1 and 2 improved significantly at 1, 3, and 6 months after the initial injection （P〈0.05）. Conclusion Multifocal electroretinography can serve as a useful modality for evaluating visual function changes in patients receiving intravitrealinjection of Lucentis for wet age-related macular degeneration.

关 键 词：多焦视网膜电图 雷珠单抗 老年性黄斑变性 脉络膜新生血管 

分 类 号：R774.5[医药卫生—眼科]