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Ranibizumab in neovascular age-related macular degeneration: a 5-year follow-up

机译：雷尼单抗治疗新生血管性年龄相关性黄斑变性：5年随访

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Purpose: Our aim was to evaluate an optical coherence tomography (OCT) and visual acuity (VA)-guided, variable-dosing regimen with intravitreal ranibizumab injection for treating patients with neovascular age-related macular degeneration (AMD) from 2007 to 2012. Design: This was a retrospective clinical study of 5?years follow-up in a tertiary eye center. Patients and methods: In this study, 66 patients with neovascular AMD (mean age of 74?years, SD 8.7?years) were included. We investigated the development of best-corrected visual acuity (BCVA), the number of intravitreal injections, and the central retinal thickness measured with OCT (OCT Spectralis) over 5?years of intravitreal treatment. Results: The mean number of intravitreal ranibizumab injections over 5?years was 8.8. The mean BCVA before therapy was 0.4 logarithm of the minimum angle of resolution (logMAR). After 5?years of therapy, the mean BCVA was 0.6?logMAR. In all, 16% of treated patients had stable VA over 5?years and 10% of study eyes approved their VA. The mean OCT-measured central retinal thickness at the beginning of this study was 295?μm; after 5?years of treatment, the mean central retinal thickness was 315?μm. There was an increase in central retinal thickness in 47.5% of examined eyes. Conclusion: Other studies showed VA improvement in OCT-guided variable-dosing regimens. Our study revealed a moderate decrease in VA after a total mean injection number as low as 8.8?injections over 5?years. In OCT, an increase in central retinal thickness over 5?years could be observed. Probably, this is due to deficient treatment when comparing the total injection number to other treatment regimens. Anti-VEGF therapy helps to keep the VA stable for a period of time, but cannot totally stop the progression of the disease completely. Patients with late stages of neovascular AMD can maintain VA even if they are relatively undertreated.
机译：目的：我们的目的是评估玻璃体腔注射兰尼单抗注射液的光学相干断层扫描（OCT）和视敏度（VA）指导的可变剂量方案，从2007年至2012年治疗新血管性年龄相关性黄斑变性（AMD）患者。 ：这是对三级眼科中心进行5年随访的回顾性临床研究。患者和方法：本研究纳入66例新血管性AMD患者（平均年龄74岁，SD 8.7岁）。我们研究了在玻璃体内治疗5年以上时最佳矫正视敏度（BCVA），玻璃体内注射次数和视网膜中央视网膜厚度的变化情况，使用OCT（OCT Spectralis）进行了测量。结果：5年内玻璃体内雷珠单抗注射的平均次数为8.8。治疗前的平均BCVA为最小分辨角（logMAR）的0.4对数。经过5年的治疗，平均BCVA为0.6？logMAR。总共有16％的接受治疗的患者在5年内具有稳定的VA，并且有10％的研究眼睛批准了他们的VA。在研究开始时，OCT测得的视网膜中央视网膜平均厚度为295？μm。治疗5年后，视网膜中央平均厚度为315μm。 47.5％的被检眼中央视网膜厚度增加。结论：其他研究表明，OCT指导的可变剂量方案的VA改善。我们的研究显示，在5年内，平均总注射次数低至8.8次注射后，VA适度下降。在OCT中，可以观察到视网膜中央厚度在5年内增加。可能是由于将总注射数与其他治疗方案进行比较时治疗不足所致。抗VEGF治疗有助于在一段时间内保持VA稳定，但不能完全完全阻止疾病的进展。晚期血管新生AMD患者即使相对治疗不足也可以维持VA。

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