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[摘要]
目的:评价玻璃体内注射雷珠单抗治疗病理性近视脉络膜新生血管的视力和解剖结果。
方法:本文为回顾性病例性研究。本研究纳入35例患眼。所有患眼依据持续或复发性脉络膜新生血管(CNV)进行一次初始计量为0.5mg的雷珠单抗玻璃体内注射治疗。最佳矫正视力(BCVA),荧光素眼底血管造影(FFA)显示的CNV,光学相干断层扫描(OCT)显示的中央视网膜厚度(CRT),治疗总次数和并发症都将作为评估指标。
结果:平均随访时间20mo(范围:16~24mo), 28例(80%)患眼随访超过22mo。治疗后基线平均最佳矫正视力(BCVA)logMAR 0.74±0.23显著提高到BCVA logMAR 0.49±0.31(P<0.001, Wilcoxon秩检验)。末次随访,35例患眼中21例(60%)显示BCVA提高2行或2行以上,13例(37%)BCVA没有变化,1例(3%)BCVA下降2行以上。平均中央视网膜厚度(CRT)从297±72μm下降到228±61μm(P<0.001, 配对t检验)。随访期间,平均注射次数是3.2次(SD, 0.94; 范围1~7次)。治疗后未发现并发症。
结论:本研究的结果显示雷珠单抗玻璃体内注射治疗病理性近视CNV是安全和有效的。
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[Abstract]
AIM: To evaluate the visual and anatomic outcomes of intravitreal ranibizumab injections for myopic choroidal neovascularization(mCNV)in Chinese patients.
METHODS: This study is a retrospective case. Thirty-five patients treated for mCNV were included in this study. Their eyes were treated with a single intravitreal injection of 0.5 mg ranibizumab following a pro re nata(PRN)regimen indicated by persistent or recurrent CNV. Best corrected visual acuity(BCVA), CNV findings on fundus fluorescent angiography(FFA), central retinal thickness(CRT)on optical coherence tomography(OCT), total number of treatments, and complications were evaluated.
RESULTS:The mean follow-up duration was 20mo(range 16-24mo). Twenty-eight patients(80%)were followed up for more 22mo. The mean baseline BCVA was 0.74 logarithm of the minimum angle of resolution(logMAR)\〖standard deviation(SD)0.23\〗 and improved significantly to 0.49 logMAR(SD 0.31)(P<0.001, Wilcoxon signed-rank test)after treatment. At the final months of follow-up, 21 of the 35 eyes(60%)showed an improvement of 2 lines or more in BCVA, 13 eyes(37%)remained unchanged, and 1 eye(3%)had a deterioration of 2 lines or more. Mean CRT decreased from 297 μm(SD, 72)at baseline to 228 μm(SD, 61)at the final follow-up(P<0.001, paired t-test). During follow-up, the mean number of repeat injections was 3.2(SD, 0.94; range, 1-7 injections). No drug-related complications were observed after treatment.
CONCLUSION:The long-term outcomes observed in this study suggest that intravitreal ranibizumab is safe and effective for treating mCNV.
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