玻璃体腔注射雷珠单抗治疗特发性脉络膜新生血管的长期疗效

Objective: To observe the long-term clinical efficacy of intravitreal ranibizumab (IVR) in patients with idiopathic choroidal neovascularization (ICNV), and to explore the indicators that affect curative effect. Methods: A retrospective self-controlled study was performed.The clinical data of 61 ICNV patients (61 eyes) from January 2013 to May 2014 in the First Affiliated Hospital of Xi'an Jiaotong University were Collected.The best corrected visual acuity (BCVA), the central retinal thickness (CRT), the height of pigment epithelium detachment (PED) and the defect length of ellipsoidal zone (EZ) before and after treatment were analyzed, the baseline clinical indicators were compared among different IVR treatment times and ICNV types. Results: The mean follow-up time was (41.5±4.6) months.The mean BCVA (LogMAR) were 0.59±0.32 and 0.17±0.12, the mean CRT were (331.18±80.42)μm and (245.07±44.67)μm, the mean height of PED were (246.73±104.75)μm and (205.78±117.01)μm and the mean defect length of EZ were (2 315.10±1 233.77)μm and (1 325.98±1 157.30)μm before and after treatment, respectively, with significant differences between before and after treatment (all at P<0.05). Fifty-three patients (86.89%) completed the treatment in the first year or within three times.The mean CRT and the height of PED in the IVR≥3 times treatment group were significantly higher than those in the IVR 1 times treatment group (all at P<0.05). There was no significant difference in the average treatment times among inferior lateral of macular fovea, side of macular fovea and outside of macular fovea (F=1.982, P>0.05). Conclusions: IVR therapy for ICNV is well tolerated with an improvement in BCVA, CRT, height of PED and defect length of EZ.The majority of patients can complete the treatment within 1 year, and most patients can be cured within 3 times treatments.The number of treatments may be associated with the CRT and the height of PED at baseline.