玻璃体腔注射雷珠单抗对息肉状脉络膜血管病变中心凹下脉络膜厚度的影响
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摘要
目的:观察玻璃体腔注射雷珠单抗对息肉状脉络膜血管病变(PCV)中心凹下脉络膜厚度的影响。方法:回顾性分析2015年1月-2016年6月于武汉大学人民医院确诊为PCV患者32例(32只眼)。所有患者行视力、眼底荧光造影(FFA)、吲哚青绿血管造影(ICGA)和频域相干断层成像(SD-OCT)检查。抗血管内皮生长因子(VEGF)治疗患者玻璃体腔注射10 mg/mL雷珠单抗0.05 ml(含雷珠单抗0.5 mg),注射方案为3+PRN。治疗后随访时间至少6个月,观察患者治疗前后视力、中心视网膜厚度(CRT)和黄斑中心凹下脉络膜厚度(SFCT)的变化。结果:抗VEGF治疗前平均视力为logMAR(0.84±0.26),治疗后6个月为logMAR(0.56±0.30),较治疗前提高logMAR(0.28±0.36);CRT治疗前为(354.32±107.64)μm,治疗后6个月为(253.47±79.56)μm,厚度明显变薄(P<0.01);SFCT从治疗前(285.09±75.93)μm变为治疗后(249.76±69.05)μm,厚度明显变薄(P<0.05)。结论:玻璃体腔注射雷珠单抗能够降低中心凹下脉络膜厚度,脉络膜厚度的基线水平可能是影响PCV患者预后的重要因素之一。
Objective: To obverse the effects of intravitreal ranibizumab injection on choroidal thickness for polypoid choroidal vasculopathy(PCV). Methods: Thirty-two PCV patients(32 eyes) were enrolled in this retrospective case study. All patients underwent visual acuity, fluorescein fundus angiography(FFA), indocyanine green angiography(ICGA),and spectral-domain optical coherence tomography(SD-OCT). The patients were received 0.5 mg(0.05 mL) ranibizumab injection. The injection protocol was 3 plus PRN. The follow-up time was at least 6 months. The changes of visual acuity, central retinal thickness(CRT) and subfoveal choroidal thickness(SFCT) were observed before and after treatment. Results: Within the 6 months after treatment, the mean visual acuity in anti-VEGF group was logMAR(0.56± 0.30), improved by(0.28± 0.36) compared with that of pre-treatment. While,the CRT of post-treatment(253.47±79.56) μm was less than that of pre-treatment(354.32±107.64)μm(P<0.01). Meanwhile, there was significant difference on SFCT before and after treatment as(285.09± 75.93) μm vs(249.76± 69.05) μm(P<0.05). Conclusion: Intravitreal ranibizumab injection can reduce the central choroidal thickness and the baseline of choroidal thickness, which may be one of the important factors that influence the prognosis of patients with PCV
Objective: To obverse the effects of intravitreal ranibizumab injection on choroidal thickness for polypoid choroidal vasculopathy(PCV). Methods: Thirty-two PCV patients(32 eyes) were enrolled in this retrospective case study. All patients underwent visual acuity, fluorescein fundus angiography(FFA), indocyanine green angiography(ICGA),and spectral-domain optical coherence tomography(SD-OCT). The patients were received 0.5 mg(0.05 mL) ranibizumab injection. The injection protocol was 3 plus PRN. The follow-up time was at least 6 months. The changes of visual acuity, central retinal thickness(CRT) and subfoveal choroidal thickness(SFCT) were observed before and after treatment. Results: Within the 6 months after treatment, the mean visual acuity in anti-VEGF group was logMAR(0.56± 0.30), improved by(0.28± 0.36) compared with that of pre-treatment. While,the CRT of post-treatment(253.47±79.56) μm was less than that of pre-treatment(354.32±107.64)μm(P<0.01). Meanwhile, there was significant difference on SFCT before and after treatment as(285.09± 75.93) μm vs(249.76± 69.05) μm(P<0.05). Conclusion: Intravitreal ranibizumab injection can reduce the central choroidal thickness and the baseline of choroidal thickness, which may be one of the important factors that influence the prognosis of patients with PCV
引文
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[13]Lee WK,Baek J,Dansingani KK,et al.Choroidal morphology in eyes with polypoidal choroidal vasculopathy and normal or subnormal subfoveal choroidal thickness[J].Retina,2016,36(Suppl 1):S73-S82.
[14]Ellabban AA,Tsujikawa A,Ogino K,et al.Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization[J].Clin Ophthalmol,2012,6:837-844.
[15]Ogasawara M,Maruko I,Sugano Y,et al.Retinal and choroidal thickness changes following intravitreal ranibizumab injection for exudative age-related macular degeneration[J].Nippon Ganka Gakkai Zasshi,2012,116(7):643-649.
[16]Yamazaki T,Koizumi H,Yamagishi T,et al.Subfoveal choroidal thickness after ranibizumab therapy for neovascular age-related macular degeneration:12-month results[J].Ophthalmology,2012,119(8):1 621-1 627.
[2]Maruko I,Iida T,Oyamada H,et al.Choroidal thickness changes after intravitreal ranibizumab and photodynamic therapy in recurrent polypoidal choroidal vasculopathy[J].Am J Ophthalmol,2013,156(3):548-556.
[3]Maruko I,Iida T,Sugano Y,et al.Subfoveal choroidal thickness after treatment of central serous chorioretinopathy[J].Ophthalmology,2010,117(9):1 792-1 799.
[4]Ting DS,Ng WY,Ng SR,et al.Choroidal thickness changes in age-related macular degeneration and polypoidal choroidal vasculopathy:A 12-month prospective study[J].Am J Ophthalmol,2016,164:128-136.
[5]Koh AH,Chen LJ,Chen SJ,et al.Polypoidal choroidal vasculopathy:evidence-based guidelines for clinical diagnosis and treatment[J].Retina,2013,33(4):686-716.
[6]Hata M,Tsujikawa A,Miyake M,et al.Two-year visual outcome of polypoidal choroidal vasculopathy treated with photodynamic therapy combined with intravitreal injections of ranibizumab[J].Graefes Arch Clin Exp Ophthalmol,2015,253(2):189-197.
[7]Chung SE,Kang SW,Kim JH,et al.Engorgement of vortex vein and polypoidal choroidal vasculopathy[J].Retina,2013,33(4):834-840.
[8]Nakashizuka H,Mitsumata M,Okisaka S,et al.Clinicopathologic findings in polypoidal choroidal vasculopathy[J].Invest Ophthalmol Vis Sci,2008,49(11):4 729-4 737.
[9]Yu PK,Tan PE,Cringle SJ,et al.Phenotypic heterogeneity in the endothelium of the human vortex vein system[J].Exp Eye Res,2013,115:144-152.
[10]Warrow DJ,Hoang QV,Freund KB.Pachychoroid pigment epitheliopathy[J].Retina,2013,33(8):1 659-1 672.
[11]Koizumi H,Kano M,Yamamoto A,et al.Short-term changes in choroidal thickness after aflibercept therapy for neovascular age-related macular degeneration[J].Am J Ophthalmol,2015,159(4):627-633.
[12]Koizumi H,Yamagishi T,Yamazaki T,et al.Subfoveal choroidal thickness in typical age-related macular degeneration and polypoidal choroidal vasculopathy[J].Graefes Arch Clin Exp Ophthalmol,2011,249(8):1 123-1 128.
[13]Lee WK,Baek J,Dansingani KK,et al.Choroidal morphology in eyes with polypoidal choroidal vasculopathy and normal or subnormal subfoveal choroidal thickness[J].Retina,2016,36(Suppl 1):S73-S82.
[14]Ellabban AA,Tsujikawa A,Ogino K,et al.Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization[J].Clin Ophthalmol,2012,6:837-844.
[15]Ogasawara M,Maruko I,Sugano Y,et al.Retinal and choroidal thickness changes following intravitreal ranibizumab injection for exudative age-related macular degeneration[J].Nippon Ganka Gakkai Zasshi,2012,116(7):643-649.
[16]Yamazaki T,Koizumi H,Yamagishi T,et al.Subfoveal choroidal thickness after ranibizumab therapy for neovascular age-related macular degeneration:12-month results[J].Ophthalmology,2012,119(8):1 621-1 627.