抗血管内皮生长因子单克隆抗体Ranibizumab治疗湿性年龄相关性黄斑变性方案的探索

发布时间：2018-01-25 09:08

本文关键词： 黄斑变性脉络膜新生血管化单克隆抗体光学相干断层扫描　出处：《眼科新进展》2014年11期 　论文类型：期刊论文

【摘要】：目的观察渗出性年龄相关性黄斑变性经玻璃体内注射Ranibizumab治疗前后的变化情况。方法对2012年10月至2014年3月在我院经眼科相关检查确诊为湿性年龄相关性黄斑变性的患者32例34眼,均接受Ranibizumab(10 mg·mL-1)0.05 mL玻璃体内注射,22眼采用1+PRN方案,另12只较为严重眼行3+PRN方案注射,使用国际标准糖尿病早期治疗研究(EDTRS)视力表检查,术前查最佳矫正视力、眼压、OCT以及眼底荧光血管造影或吲哚青绿血管造影,随访3~11个月,分别于术后1周、2周、1个月、以后每个月观察黄斑OCT、视力、眼压,必要时查FFA、ICGA等相关指标并进行统计学分析。结果所有患眼注射(2.17±1.05)次,随访3个月、6个月时ETDRS视力分别为(34.37±12.75)个字母、(38.06±11.38)个字母,较治疗前分别提高(5.63±3.17)个字母、(9.27±5.01)个字母,差异有统计学意义(均为P=0.00)。治疗后1个月,黄斑区脉络膜新生血管基底部宽度、高度分别为(2001.83±90.71)μm、(347.23±63.73)μm,与治疗前(385.63±92.57)μm差异均有统计学意义(均为P=0.00)。治疗后1个月黄斑中心视网膜厚度为(336.90±82.11),与治疗前差异有统计学意义(P=0.00)。随访期间未发现全身及眼部严重不良反应。结论湿性年龄相关性黄斑变性的玻璃体内注射Ranibizumab治疗能明显缩小病灶,消退黄斑水肿,相应改善视功能,OCT检查测量CNV生物学参数具有无创、安全可靠、简单易行的优点,是一种重要的观察方法。
[Abstract]:Objective to observe the changes of exudative age-related macular degeneration before and after intravitreous injection of Ranibizumab. 32 cases (34 eyes) were diagnosed as wettable age-related macular degeneration. 22 eyes received intravitreous injection of Ranibizumab(10 mg 路mL-1)0.05 mL with 1 PRN regimen. The other 12 severe eyes were injected with 3 PRN regimen, and EDTRS visual acuity chart was used to check the best corrected visual acuity (BCVA) and intraocular pressure (IOP) before operation. OCT, fundus fluorescein angiography or indocyanine green angiography were followed up for 3 to 11 months. Macular OCTs, visual acuity and intraocular pressure were observed at 1 week and 1 month after operation. When necessary, FFA-ICGA and other related indexes were examined and analyzed statistically. Results all patients were given 2.17 卤1.05 injections and followed up for 3 months. At 6 months, the visual acuity of ETDRS was 34.37 卤12.75 letters and 38.06 卤11.38 letters respectively. Compared with before treatment, 5.63 卤3.17) letters were increased by 9.27 卤5.01 letters, the difference was statistically significant (P < 0.001). The width and height of choroidal neovascularization in macular area were 347.23 卤63.73 渭 m and 2001.83 卤90.71 渭 m, respectively. There was a significant difference in the retinal thickness of macular center between 385.63 卤92.57 渭 m and 385.63 卤92.57 渭 m before treatment (P < 0.001). The retinal thickness of macular center was 336.90 卤82.11 1 month after treatment. . There was significant difference between before treatment and before treatment. During the follow-up, no serious adverse reactions were found in the whole body and eyes. Conclusion Intravitreous injection of Ranibizumab in patients with wettable age-related macular degeneration can significantly reduce the focus. Regression of macular edema and improvement of visual function by Oct in the measurement of CNV biological parameters have the advantages of noninvasive, safe, reliable, simple and easy to carry out. It is an important observation method.
【作者单位】：西安交通大学医学院附属汉中3201医院;
【分类号】：R774.5
【正文快照】： 年龄相关性黄斑变性(aged-ralated macular de-generation,AMD)时脉络膜新生血管(choroidal neo-vascularization,CNV)突破Bruch膜生长进入视网膜色素上皮或神经上皮下,由于管壁的通透性高于正常血管,极易引起出血、渗出,继而形成瘢痕,造成黄斑损伤,严重影响中心视力,甚至致

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