[1]孙早荷,万光明,钱诚,等.玻璃体内注射雷珠单抗治疗病理性近视继发脉络膜新生血管[J].眼科新进展,2018,38(10):925-929.[doi:10.13389/j.cnki.rao.2018.0219]
　SUN Zao-He,WAN Guang-Ming,QIAN Cheng,et al.Efficacy of intravitreal ranibizumab for the treatment of choroidal neovascularization secondary to pathological myopia[J].Recent Advances in Ophthalmology,2018,38(10):925-929.[doi:10.13389/j.cnki.rao.2018.0219]
点击复制

玻璃体内注射雷珠单抗治疗病理性近视继发脉络膜新生血管/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年10期
页码:
925-929
栏目:
近视专题
出版日期:
2018-10-05

文章信息/Info

Title:
Efficacy of intravitreal ranibizumab for the treatment of choroidal neovascularization secondary to pathological myopia
作者:
孙早荷; 万光明; 钱诚; 梁申芝; 王炯
450052　河南省郑州市，郑州大学第一附属医院眼科
Author(s):
SUN Zao-He; WAN Guang-Ming; QIAN Cheng; LIANG Shen-Zhi; WANG Jiong
Department of Ophthalmology，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，Henan Province，China
关键词:
脉络膜新生血管; 病理性近视; 雷珠单抗
Keywords:
choroidal neovascularization; pathological myopia; ranibizumab
分类号:
R778.1
DOI:
10.13389/j.cnki.rao.2018.0219
文献标志码:
A
摘要:
目的　对比观察玻璃体内注射雷珠单抗的两种方案治疗病理性近视（pathological myopia，PM）继发脉络膜新生血管（choroidal neovascularization，CNV）的临床疗效。方法　收集2016年1月至2017年6月在我院接受治疗的PM-CNV患者49例（49眼）纳入本研究。所有患眼均行玻璃体内注射雷珠单抗（0.05 mL，含雷珠单抗0.5 mg）治疗。依据接受治疗情况将患者分为1+PRN组（注射一次后再按需注射）25例25眼、3+PRN组（连续注射3个月后再按需注射）24例24眼。随访时间为12个月。比较治疗后两组患眼的平均治疗次数、最佳矫正视力（best corrected visual acuity，BCVA）、黄斑中心凹视网膜厚度（central macular thickness，CMT）以及CNV渗漏变化情况。结果　1+PRN组、3+PRN组患眼治疗次数分别为（1.92±1.12）次、（3.21±0.42）次，差异有统计学意义（Z=-4.056，P=0.000）。治疗后6个月、12个月，1+PRN组患眼BCVA分别为（0.57±0.28）logMAR、（0.50±0.26）logMAR，3+PRN组患眼BCVA分别为（0.58±0.22）logMAR、（0.51±0.25）logMAR，两组治疗后同一时间点BCVA比较，差异均无统计学意义（t=-0.214、-0.172，P=0.831、0.864）。治疗后6个月、12个月，1+PRN组患眼CMT值分别为（285.16±66.08）μm、（247.40±55.10）μm，3+PRN组患眼CMT值分别为（286.29±29.53）μm、（241.04±35.39）μm，两组治疗后同一时间点CMT比较，差异均无统计学意义（t’=-0.080、-0.480，P=0.938、0.632）。治疗后12个月，1+PRN组、3+PRN组治疗总有效率分别为84%、92%，两组患眼CNV渗漏治疗总有效率的比较，差异无统计学意义（χ2=0.146，P=0.702）。结论　1+PRN方案在保证疗效的前提下减少了注药次数，提示1+PRN方案更适合于PM-CNV的治疗。
Abstract:
Objective　To compare the clinical efficacy of two different intravitreal ranibizumab injection regimens in patients with choroidal neovascularization （CNV） secondary to pathological myopia （PM）.Methods　Forty-nine eyes of 49 patients with PM-CNV in our hospital from January 2016 to June 2017 were enrolled into this study.All patients were treated with intravitreal injection of 0.05 mL ranibizumab （10 g·L-1）.The patients were divided into two groups：1+PRN group including 25 patients （25 eyes） treated with a single intravitreal injection and 3+PRN group including 24 patients （24 eyes） treated with three consecutive monthly intravitreal injections.The follow-up period was 12 months.The mean times of injection，best corrected visual acuity （BCVA），central macular thickness （CMT） and leakage of CNV after treatment were compared.Results　The mean times of injection in the 1+PRN group and 3+PRN group were 1.92±1.12 and 3.21±0.42 respectively，and the difference between the two groups was statistically significant （Z=-4.056，P=0.000）.At 6 months and 12 months after treatment，the BCVA was （0.57±0.28） logMAR and （0.50±0.26） logMAR in the 1+PRN group，and （0.58±0.22） logMAR and （0.51±0.25） logMAR in the 3+PRN group，respectively.There were no significant difference in BCVA between the two groups at each time point （t=-0.214，-0.172 and P=0.831，0.864，respectively）.The CMT values were （285.16±66.08）μm and （247.40±55.10）μm in the 1+PRN group，and （286.29±29.53）μm and （241.04±35.39）μm in the 3+PRN group at 6 months and 12 months after treatment，respectively.There were no statistical difference in CMT values of the two groups at the both time points （t’=-0.080，-0.480 and P=0.938，0.632，respectively）.The overall rates of efficacy of CNV leakage were 84% and 92% in the 1+PRN group and 3+PRN group，respectively.At 12 months after treatment，the difference was not statistically significant （χ2=0.146，P=0.702）.Conclusion　The 1+PRN regimen decreases the times of total injections for guaranteeing the efficacy，suggesting it is a more suitable therapy to PM-CNV.

参考文献/References:

［1］　DING X Y，CHEN C L.Understanding the characteristics of myopic choroidal neovascularization to improve its diagnosis and treatment outcome and follow-up strategy［J］.Chin J Ocul Fundus Dis，2017，33（6）：564-568.
丁小燕，陈冲林.正确认识近视脉络膜新生血管的临床特征提高其诊断治疗及规范随访水平［J］.中华眼底病杂志，2017，33（6）：564-568.
［2］　IKUNO Y，JO Y，HAMASAKI T，TANO Y.Ocular risk factors for choroidal neovascularization in pathologic myopia［J］.Invest Ophthalmol Vis Sci，2010，51（7）：3721-3725.
［3］　GHARBIYA M，GIUSTOLISI R，ALLIEVI F.Choroidal neovascularization in pathologic myopia：intravitreal ranibizumab versus bevacizumab--a randomized controlled trial［J］.Am J Ophthalmol，2010，149（3）：458-464.
［4］　ZENG M，SONG Y P，DING Q.Intravitreal Conbercept for treatment of choroidal neovascularization secondary to pathologic myopia［J］.Chin J Ocul Fundus Dis，2016，32（1）：17-21.
曾苗，宋艳萍，丁琴.玻璃体腔注射康柏西普治疗病理性近视脉络膜新生血管疗效观察［J］.中华眼底病杂志，2016，32（1）：17-21.
［5］　YIZUO H Z，CHEN C Z，ZHENG H M，WONG M，CAO S.Clinical observation of intravitreal ranibizumab for treatment of choroidal neovascularization secondary to pathologic myopia［J］.Chin J Ocul Fundus Dis，2013，29（4）：367-371.
易佐慧子，陈长征，郑红梅，翁铭，曹思.抗血管内皮生长因子单克隆抗体ranibizumab治疗病理性近视脉络膜新生血管疗效观察［J］.中华眼底病杂志，2013，29（4）：367-371.
［6］　YANG X，DAI H.Intravitreal ranibizumab for the treatment of pathological myopia associated with choroidal neovascularization in Chinese patients［J］.Chin Med J（Engl），2014，127（16）：2906-2910.
［7］　WOLF S，BALCIUNIENE V J，LAGANOVSKA G，MENCHINI U，OHNO-MATSUI K，SHARMA T，et al.RADIANCE：a randomized controlled study of ranibizumab in patients with choroidal neovascularization secondary to pathologic myopia［J］.Ophthalmology，2014，121（3）：682-692.
［8］　TONG J P，CHAN W M，LIU D T，LAI T Y，CHOY K W，PANG C P，et al.Aqueous humor levels of vascular endothelial growth factor and pigment epithelium-derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization［J］.Am J Ophthalmol，2006，141（3）：456-462.
［9］　NG D S，KWOK A K，CHAN C W.Anti-vascular endothelial growth factor for myopic choroidal neovascularization［J］.Clin Exp Ophthalmol，2012，40（1）：e98-e110.
［10］　MATRI L E，CHEBIL A，KORT F.Current and emerging treatment options for myopic choroidal neovascularization［J］.Clin Ophthalmol，2015，9（3）：733-744.
［11］　DING W Z，ZOU J.Research advances in pathogenesis of choroidal neovascularization of pathologic myopia［J］.Rec Adv Ophthalmol，2014，34（10）：987-989.
丁雯芝，邹俊.病理性近视脉络膜新生血管发病机制的研究进展［J］.眼科新进展，2014，34（10）：987-989.
［12］　CUI L H，YANG Z，XU L.Efficacy of intravitreal Ranibizumab injection for choroidal neovascularization secondary to pathologic myopia［J］.Int Eye Sci，2016，16（3）：526-528.
崔丽红，杨智，徐丽.玻璃体腔注射雷珠单抗治疗病理性近视脉络膜新生血管［J］.国际眼科杂志，2016，16（3）：526-528.
［13］　YAN P S，WAN G M，DONG Y，QIAN C，CHEN Y，LI F Z，et al.Analysis on the effect of Ranibizumab combined with photodynamic therapy in the treatment of age-related macular degeneration［J］.Int Eye Sci，2017，17（5）：933-936.
闫磐石，万光明，董一，钱诚，陈悦，李福祯，等.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［J］.国际眼科杂志，2017，17（5）：933-936.
［14］　LIU L P，SONG H，JI L B，XIAO Y，LI M，CHEN Z.Intravitreal ranibizumab injections for pathologic myopia macular choroidal neovascularization［J］.Rec Adv Ophthalmol，2016，36（7）：667-670.
刘李平，宋徽，冀垒兵，肖云，李明，陈真.玻璃体内注射雷珠单抗治疗病理性近视黄斑部脉络膜新生血管［J］.眼科新进展，2016，36（7）：667-670.
［15］　MENG L，WEI W B，LI Y L，HAN X D.Clinical observation of intravitreal Ranibizumab injection for choroidal neovascularization secondary to pathologic myopia［J］.Chin J Ocul Fundus Dis，2016，32（1）：70-72.
孟王乐，魏文斌，李燕龙，韩晓冬.玻璃体腔注射雷珠单抗治疗病理性近视脉络膜新生血管的疗效观察［J］.中华眼底病杂志，2016，32（1）：70-72.
［16］　FIGURSKA M，STANKIEWICZ A.Anty-VEGF therapy in the treatment of myopic macular choroidal neovascularization--cases report［J］.Klin Oczna，2008，110（10-12）：387-391.
［17］　PASTORE M R，CAPUANO V，BRUYRE E，MIERE A，CORBELLI E，QUERQUES L，et al.Nine-year outcome of ranibizumab monotherapy for choroidal neovascularization secondary to pathologic myopia［J］.Ophthalmologica，2017，239（2-3）：133-142.
［18］　TUFAIL A，PATEL P J，SIVAPRASAD S，AMOAKU W，BROWNING A C，COLE M，et al.Ranibizumab for the treatment of choroidal neovascularization secondary to pathological myopia：interim analysis of the REPAIR study［J］.Eye，2013，27（6）：709-715.
［19］　CALVO-GONZLEZ C，RECHE-FRUTOS J，FERNNDEZ-VIGO J I，SENZ-FRANCS F，FERNNDEZ-PREZ C，GARCA-FEIJO J.Long-term outcomes of two different InitialdDosing regimens of intravitreal ranibizumab used to treat myopic choroidal neovascularization［J］.Ophthalmologica，2017，238（4）：196-204.
［20］　RUIZ-MORENO J M，MONTERO J A，AMAT-PERAL P.Myopic choroidal neovascularization treated by intravitreal bevacizumab：comparison of two different initial doses［J］.Graefes Arch Clin Exp Ophthalmol，2011，249（4）：595-599.
［21］　RUIZ-MORENO J M，MONTERO J A，ARIAS L，ARAIZ J，GOMEZ-ULLA F，SILVA R，et al.Three versus one intravitreal bevacizumab injections as initial protocol to treat myopic choroidal neovascularization［J］.Acta Ophthalmol，2012，90（1）：e82-e83.
［22］　WAKABAYASHI T，IKUNO Y，GOMI F.Different dosing of intravitreal bevacizumab for choroidal neovascularization because of pathologic myopia［J］.Retina，2011，31（5）：880-886.
［23］　IKUNO Y，OHNO-MATSUI K，WONG T Y，KOROBELNIK J F，VITTI R，LI T，et al.Intravitreal aflibercept injection in patients with myopic choroidal neovascularization：the MYRROR study［J］.Ophthalmology，2015，122（6）：1220-1227.
［24］　MIYAKE M，YAMASHIRO K，AKAGIKURASHIGE Y，KUMAGAI K，NAKATA I，NAKANISHI H，et al.Vascular endothelial growth factor gene and the response to anti-vascular endothelial growth factor treatment for choroidal neovascularization in high myopia［J］.Ophthalmology，2014，121（1）：225-233.
［25］　WANG E，CHEN Y.Intravitreal anti-vascular endothelial growth factor for choroidal neovascularization secondary to pathologic myopia：systematic review and meta-analysis［J］.Retina，2013，33（7）：1375-1392.
［26］　INHOFFEN W，ZIEMSSEN F.Morphological features of myopic choroidal neovascularization：differences to neovascular age-related macular degeneration［J］.Ophthalmologe，2012，109（8）：749-757.
［27］　LI L，WANG W J，YUAN F，ZHAO N Q，YUAN Y Z.Comparison between age-related macular degeneration and pathologic myopia with choroidal neovascularization［J］.Rec Adv Ophthalmol，2005，25（1）：49-51.
黎蕾，王文吉，袁非，赵耐青，袁源智.年龄相关性黄斑变性和病理性近视合并脉络膜新生血管的比较［J］.眼科新进展，2005，25（1）：49-51.
［28］　LU B W，WU X W.Recent advances in intravitreal injection of ranibizumab for myopic choroidal neovascularization［J］.Rec Adv Ophthalmol，2014，34（9）：897-900.
陆秉文，吴星伟.Ranibizumab玻璃体内注射治疗病理性近视脉络膜新生血管研究进展［J］.眼科新进展，2014，34（9）：897-900.

相似文献/References:

[1]党亚龙 陈彬川 穆雅林 赵满丽 朱豫.i-MP对产生2型脉络膜新生血管的年龄相关性黄斑变性患者视力及黄斑厚度的影响[J].眼科新进展,2013,33(2):000.
[2]许瑶 曾骏文.近视眼药物治疗研究进展[J].眼科新进展,2013,33(7):000.
[3]许琴 黄亮 林素香 郑水华 肖煜晨 王雅丽.激光诱导小鼠脉络膜新生血管中膜攻击物与血管生长因子的表达[J].眼科新进展,2013,33(8):000.
[4]詹文捷 梁丽娜 唐由之.骨髓来源细胞参与脉络膜新生血管形成的研究进展[J].眼科新进展,2012,32(1):000.
[5]陈丽娟 苗林.重组人血管内皮抑素对脉络膜新生血管的抑制作用[J].眼科新进展,2012,32(10):000.
[6]栾兰 姚勇.湿性年龄相关性黄斑变性的治疗进展[J].眼科新进展,2013,33(4):000.
[7]常远 王雨生 曹丰 张健 蔡岩 李鹤一 侯慧媛.在体生物发光成像术观察骨髓来源细胞参与脉络膜新生血管的形成[J].眼科新进展,2013,33(5):000.
[8]雷润佳 胡丹 张鹏 孙丽娟 白倩 闵捷.缺氧对人视网膜色素上皮细胞促血管生成素-1和促血管生成素-2表达的影响[J].眼科新进展,2013,33(5):000.
[9]王晓霞 史志洁 林娜 刘晓瑞.光学相干断层扫描在病理性近视黄斑裂孔中的应用[J].眼科新进展,2013,33(9):000.
[10]胡艳红 祁明信 郭娜 陈胜 柯发杰.渗出型年龄相关性黄斑变性患者外周血CCR3的表达[J].眼科新进展,2013,33(11):000.
[11]金昱 石安娜 刘维锋 石浔 王永波.频域OCT在光动力疗法治疗病理性近视脉络膜新生血管中的应用[J].眼科新进展,2012,32(10):000.
[12]黄志坚 宋艳萍 金中秋 丁琴 陈中山.光动力疗法联合玻璃体内注射Bevacizumab治疗病理性近视合并脉络膜新生血管[J].眼科新进展,2013,33(4):000.
[13]陆秉文,吴星伟. Ranibizumab玻璃体内注射治疗病理性近视脉络膜新生血管研究进展[J].眼科新进展,2014,34(9):897.[doi:10.13389/j.cnki.rao.2014.0248]
[14]丁雯芝,邹俊.病理性近视脉络膜新生血管发病机制的研究进展[J].眼科新进展,2014,34(10):987.[doi:10.13389/j.cnki.rao.2014.0274]
[15]田楠楠,亢泽峰,张庆.加减驻景方对病理性近视脉络膜新生血管动物模型血管内皮生长因子及色素上皮衍生因子表达的影响[J].眼科新进展,2015,35(10):906.[doi:10.13389/j.cnki.rao.2015.0247]
　TIAN Nan-Nan,KANG Ze-Feng,ZHANG Qing.Effects of modified Zhu Jing prescriptions on expression of VEGF and PEDF in pathologic myopia with choroidal neovascularization animal model[J].Recent Advances in Ophthalmology,2015,35(10):906.[doi:10.13389/j.cnki.rao.2015.0247]
[16]修立恒,李佳林,李常栋,等.玻璃体内注射雷珠单抗治疗病理性近视合并脉络膜新生血管疗效观察[J].眼科新进展,2015,35(11):1067.[doi:10.13389/j.cnki.rao.2015.0292]
　XIU Li-Heng,LI Jia-Lin,LI Chang-Dong,et al.Pathological myopia combined with choroidal neovascularization treated by intravitreal injection of ranibizumab[J].Recent Advances in Ophthalmology,2015,35(10):1067.[doi:10.13389/j.cnki.rao.2015.0292]
[17]刘李平,宋徽,冀垒兵,等.玻璃体内注射雷珠单抗治疗病理性近视黄斑部脉络膜新生血管[J].眼科新进展,2016,36(7):667.[doi:10.13389/j.cnki.rao.2016.0177]
　LIU Li-Ping,SONG Hui,JI Lei-Bing,et al.Intravitreal ranibizumab injections for pathologic myopia macular choroidal neovascularization[J].Recent Advances in Ophthalmology,2016,36(10):667.[doi:10.13389/j.cnki.rao.2016.0177]
[18]陈丛,闫明,宋艳萍.康柏西普对病理性近视脉络膜新生血管的疗效及视力预后相关性研究[J].眼科新进展,2020,40(6):569.[doi:10.13389/j.cnki.rao.2020.0131]
　CHEN Cong,YAN Ming,SONG Yanping.Efficacy of Conbercept for treatment of choroidal neovascularization with pathologic myopia and on visual prognosis[J].Recent Advances in Ophthalmology,2020,40(10):569.[doi:10.13389/j.cnki.rao.2020.0131]
[19]叶蓉,张秋阳,张荟颖,等.不同类型脉络膜新生血管患者对抗VEGF药物治疗应答的差异性[J].眼科新进展,2022,42(12):952.[doi:10.13389/j.cnki.rao.2022.0195]
　YE Rong,ZHANG Qiuyang,ZHANG Huiying,et al.Differences in responses to anti-vascular endothelial growth factor drugs of patients with different types of choroidal neovascularization[J].Recent Advances in Ophthalmology,2022,42(10):952.[doi:10.13389/j.cnki.rao.2022.0195]

更新日期/Last Update: 2018-09-28