Wu, T.T., Kung, Y.H.
脉络膜 玻璃体 预后
摘要：目的：旨在评估玻璃体内注射雷珠单抗注射治疗近视脉络膜新生血管的5年预后、疗效和安全性。方法：对14例接受雷珠单抗玻璃体腔注射治疗近视脉络膜新生血管患者的18只眼5年随访病历进行回顾性分析。预后指标包括最佳矫正视力，治疗总次数和并发症。结果：5年以上平均注射次数为4.56±3.52次。第一年后有10只眼（55.56％）无需治疗。平均最佳矫正视力从基线最小分辨角对数0.59±0.47（Snellen等效值，6/24）改善为1年时最小分辨角度对数0.32±0.35（Snellen等效值，6/13），并且在2年时最小分辨角对数为0.38±0.42（Snellen等效值，6/15）（分别为P = 0.001和0.020;配对t-检验）。 2年后，尽管平均最佳矫正视力仍优于基线，但差异无统计学意义。在5年时间里，61.11％的眼视力至少改善了1行，33.33％的视力改善了3行以上。由于疾病活动度和严重脉络膜视网膜萎缩，2只眼最终视力比基线差。结论：玻璃体腔注射雷珠单抗治疗近视脉络膜新生血管是安全有效的。第一年后只有44％的眼睛需要再治疗，5年以上60％的眼视力有所改善。
PURPOSE:To evaluate the 5-year outcomes, efficacy, and safety of intravitreal ranibizumab injections for the treatment of myopic choroidal neovascularization.METHODS:The medical records of 18 consecutive eyes of 14 patients who received intravitreal injections of ranibizumab for myopic choroidal neovascularization with a follow-up of 5 years were retrospectively reviewed. Outcomes included best-corrected visual acuity, total number of treatments, and complications.RESULTS:The average number of injections over 5 years was 4.56 ± 3.52. Ten eyes (55.56%) had no need for treatment after the first year. Mean best-corrected visual acuity improved from 0.59 ± 0.47 logarithm of the minimum angle of resolution (Snellen equivalent, 6/24) at baseline to 0.32 ± 0.35 logarithm of the minimum angle of resolution (Snellen equivalent, 6/13) at 1 year, and to 0.38 ± 0.42 logarithm of the minimum angle of resolution (Snellen equivalent, 6/15) at 2 years (P = 0.001 and 0.020, respectively; paired t-test). After 2 years, although mean best-corrected visual acuity remained better than baseline, the difference was not statistically significant. At 5 years, vision improved by at least 1 line for 61.11% of eyes and by more than 3 lines for 33.33%. The final visual acuity of 2 eyes was worse than baseline because of disease activity and profound chorioretinal atrophy, which increased in six eyes. No complications were noted.CONCLUSION:Intravitreal ranibizumab was safe and effective for treating myopic choroidal neovascularization. Only 44% of eyes required retreatment after the first year, and vision improved in more than 60% of eyes over 5 years.