Ranibizumab治疗老年黄斑变性合并脉络膜新生血管短期临床观察

Treatment of senile macular degeneration complicated by choroidal neovascularization with ranibizumab

  • 摘要: 目的 观察Ranibizumab(Lucentis)治疗渗出型老年黄斑变性(Aga-Related Macular Degeneration,AMD)合并脉络膜新生血管(Choroidal Neovascularization,CNV)的短期治疗效果。方法 经荧光素眼底血管造影(Fundus Fluorescein Angiography,FFA)、吲哚青绿血管造影(Indocyanine Geen Angiography,ICGA)和光学相干断层成像术(Optic Coherence Tomography,OCT)等检查确诊30例渗出型AMD患者的30只患眼行每月1次Lucentis治疗,共3次,剂量为0.5mg(0.05ml);玻璃体腔注入,治疗前和治疗后1周,1、3个月的临床资料,以视力、眼压、FFA、ICGA、OCT检查结果为观察指标,评价Lucentis对渗出型AMD的短期治疗效果。结果 30例治疗后1个月视力稳定19例(63.3%),视力提高11例(36.7%);3个月30例视力稳定16例(55.2%),视力提高13例(44.8%),1例治疗后2月时发生脑梗停止治疗。30例治疗后1h有4例眼压升高>20mmHg(1mmHg=0.133kPa),最高23.8mmHg;1d、1个月眼压均在正常范围内。FFA和ICGA检查显示均有不同程度渗漏减轻或消退。OCT检查显示视网膜水肿和浆液性脱离明显好转。治疗后无明显不良反应,仅有轻微眼部局限性结膜充血、结膜下出血、眼前小暗影;个别眼压轻微升高等,一般5d内恢复正常。结论 Lucentis玻璃体腔注射治疗渗出型AMD安全有效。

     

    Abstract: Objective To observe the short-term therapeutic effect of ranibizumab(Lucentis) on senile macular degeneration(MD)complicated by choroidal neovascularization(CNV).Methods A definite diagnosis of exudative senile MD was made in 30 cases by fundus fluorescein angiography(FFA),indocyanine geen angiography(ICGA) and optic coherence tomography(OCT).Exudative senile MD was treated 3 times with Lucentis by cavum vitreum injection at a dose of 0.5mg(0.05ml),once a month.Clinical data were collected 1 week,1 and 3 months before and after treatment.Acuity of vision,intraocular pressue,and findings in FFA,ICGA and OCT were used as parameters of the short-term effect of Lucentis on exudative senile MD.Results The acuity of vision became stable in 19(63.3%)and improved in 11(36.7%) out of the 30 cases 1 month after treatment,and became stable in 16(55.2%) and improved in 13(44.8%) out of the 30 cases 3 months after treatment.The intraocular pressure was elevated over 20mmHg and reached its peak of 23.8mmHg in 4 out of the 30 cases 1h after treatment,and maintained normal for 1 day and 1 month,respectively after treatment.FFA and ICGA showed that the exudates were decreased or resolved at different extents.OCT displayed that retinal edema and serous detachment were significantly improved after treatment,with no obvious adverse effects except for mild localized conjunctival congestion,subconjunctival hemorrhage,small umbra in visual field,and slightly increased intraocular pressure,which could recover in less than 5 days after treatment.Treatment was terminated in 1 case because of cerebral infarction.Conclusion Injection of Lucentis into vitreous cavity is a safe and effective modality for exudative senile MD.

     

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