雷珠单抗联合光动力疗法对年龄相关性黄斑变性CNV的治疗效果
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摘要
目的:探讨雷珠单抗联合光动力疗法治疗年龄相关性黄斑变性对脉络膜新生血管(choroidal neovascularization,CNV)渗漏及视力的影响。方法:选取2012-01/2015-12在我院接受治疗的78例86眼年龄相关性黄斑变性患者作为研究对象,采用随机数字表分为联合组(雷珠单抗联合光动力疗法)39例42眼、对照组(单用雷珠单抗治疗)39例44眼,对比两组患者治疗前后的视力、CNV渗漏情况变化。结果:治疗后第6、12wk,联合组患者的最佳矫正视力(best corrected visual acuity,BCVA)测定值均大于对照组,差异具有统计学意义(P<0.05);联合组患者的黄斑中心凹视网膜厚度(central macular retinal thick,CRT)测定值均小于对照组,差异具有统计学意义(P<0.05);治疗12wk后,联合组的CNV渗漏治疗总有效率(90%)与对照组(82%)比较,差异无统计学意义(P>0.05)。结论:雷珠单抗联合光动力疗法治疗年龄相关性黄斑变性对CNV渗漏、视力及CRT均具有较好的改善作用。
AIM:To investigate the effect of combination therapy with Ranibizumab and photodynamic therapy in the treatment of age-related macular degeneration. METHODS:Totally 78 cases(86 eyes) with age-related macular degeneration in our hospital from January 2012 to December 2015 were selected as the subjects.The patients were randomly divided into two groups,39 cases(42eyes) were treated by combination as the combination group and 39 cases(44 eyes) as the control group(only treated with ranibizumab).The changes of visual acuity and choroidal neovascularization(CNV) leakage were compared between the two groups before and after treatment. RESULTS:After treatment for 6 and 12 wk,the best corrected visual acuity(BCVA) value of the combined group was higher than that of the control group,the difference was statistically significant(P<0.05);the central retinal thickness(CRT) values of the patients in the combined group were lower than those in the control group,the difference was statistically significant(P<0.05).After 12 wk of treatment,the total effective rate for CNV leakage in the combined group was 90%compared with that of the control group(82%),there was no significant difference(P>0.05). CONCLUSION:The efficacy of the combination therapy is good for CNV leakage,visual acuity and CRT in patients with age-related macular degeneration.
AIM:To investigate the effect of combination therapy with Ranibizumab and photodynamic therapy in the treatment of age-related macular degeneration. METHODS:Totally 78 cases(86 eyes) with age-related macular degeneration in our hospital from January 2012 to December 2015 were selected as the subjects.The patients were randomly divided into two groups,39 cases(42eyes) were treated by combination as the combination group and 39 cases(44 eyes) as the control group(only treated with ranibizumab).The changes of visual acuity and choroidal neovascularization(CNV) leakage were compared between the two groups before and after treatment. RESULTS:After treatment for 6 and 12 wk,the best corrected visual acuity(BCVA) value of the combined group was higher than that of the control group,the difference was statistically significant(P<0.05);the central retinal thickness(CRT) values of the patients in the combined group were lower than those in the control group,the difference was statistically significant(P<0.05).After 12 wk of treatment,the total effective rate for CNV leakage in the combined group was 90%compared with that of the control group(82%),there was no significant difference(P>0.05). CONCLUSION:The efficacy of the combination therapy is good for CNV leakage,visual acuity and CRT in patients with age-related macular degeneration.
引文
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6 白玉婧,黎晓新.新生血管性老年性黄斑变性药物治疗面临的挑战与未来的发展趋势.中华眼底病杂志2016;32(1):3-7
7 蔡锡安,彭惠.两种抗VEGF药物治疗渗出性年龄相关性黄斑病变的疗效.国际眼科杂志2016;16(8):1501-1502
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9 田晓燕,刘涛,魏静,等.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.眼科新进展2014;34(11):1062-1064
10 黄萍,王雯倩,石砚,等.贝伐单抗联合小梁切除术或睫状体光凝术治疗晚期新生血管性青光眼疗效比较.中华实验眼科杂志2015;33(4):362-366
11 侯宪如,程湧,张琦,等.玻璃体腔注射卡铂联合贝伐单抗治疗难治型视网膜母细胞瘤的疗效观察.中华眼科杂志2015;13(2):126-129
12 Kriechbaum K,prage S,Mylonas G,et al.lntravitreal bevacizumab(AVastin)versus triamcinolone(Volon A)for treatment of diabetic macular edemaone-yeat tesults.Eye(Lond)2014;28(1):9-15
13 马臻,王海燕,王雨生,等.光学相干断层扫描引导的贝伐单抗眼内注射治疗湿性年龄相关性黄斑变性的疗效分析.中华眼底病杂志2013;29(4):357-361
14梁书增,程辉,张雪梅.创伤性膈肌破裂的早期诊断和外科治疗.中华全科医学2016;14(3):394-396
15 金昱,石安娜,刘淼.玻璃体内注射雷珠单抗(Ranibizumab)治疗视网膜静脉阻塞继发黄斑水肿.眼科新进展2014;34(9):855-857
2 Bakall B,Folk JC,Boldt HC,et al.Aflibercept therapy for exudative age-related macular degeneration resistant to bevacizumab and ranibizumab.Am J Ophthalmol 2013;156(1):15-22
3 黎晓新.普及推广“中国老年性黄斑变性临床诊断治疗路径”规范老年性黄斑变性的诊断治疗.中华眼底病杂志2013;29(4):341-342
4 Chang AA,Li H,Broadhead GK,et al.Intravitreal aflibercept for treatment-resistant neovascular age-relatedmacular degeneration.Ophthalmology 2014;121(1):188-192
5 Kumar N,Marsiglia M,Mrejen S,et al.Visual and anatomical outcomes of intravitreal aflibercept in eyes with persistent subfoveal fluid despite previous treatments with ranibizumab in patients with neovascularage related macular degeneration.Retina 2013;33(8):1605-1612
6 白玉婧,黎晓新.新生血管性老年性黄斑变性药物治疗面临的挑战与未来的发展趋势.中华眼底病杂志2016;32(1):3-7
7 蔡锡安,彭惠.两种抗VEGF药物治疗渗出性年龄相关性黄斑病变的疗效.国际眼科杂志2016;16(8):1501-1502
8 曾仁攀,梁小琼,王国平,等.新型抗VEGF融合蛋白Conbercept玻璃体腔注射治疗湿性年龄相关性黄斑变性的疗效评价.临床眼科杂志2015;12(3):216-219
9 田晓燕,刘涛,魏静,等.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.眼科新进展2014;34(11):1062-1064
10 黄萍,王雯倩,石砚,等.贝伐单抗联合小梁切除术或睫状体光凝术治疗晚期新生血管性青光眼疗效比较.中华实验眼科杂志2015;33(4):362-366
11 侯宪如,程湧,张琦,等.玻璃体腔注射卡铂联合贝伐单抗治疗难治型视网膜母细胞瘤的疗效观察.中华眼科杂志2015;13(2):126-129
12 Kriechbaum K,prage S,Mylonas G,et al.lntravitreal bevacizumab(AVastin)versus triamcinolone(Volon A)for treatment of diabetic macular edemaone-yeat tesults.Eye(Lond)2014;28(1):9-15
13 马臻,王海燕,王雨生,等.光学相干断层扫描引导的贝伐单抗眼内注射治疗湿性年龄相关性黄斑变性的疗效分析.中华眼底病杂志2013;29(4):357-361
14梁书增,程辉,张雪梅.创伤性膈肌破裂的早期诊断和外科治疗.中华全科医学2016;14(3):394-396
15 金昱,石安娜,刘淼.玻璃体内注射雷珠单抗(Ranibizumab)治疗视网膜静脉阻塞继发黄斑水肿.眼科新进展2014;34(9):855-857