阿柏西普与雷珠单抗治疗湿性黄斑变性的效果比较

目的:比较阿柏西普与雷珠单抗玻璃体内注射治疗湿性年龄相关性黄斑变性(AMD)的临床效果。方法:前瞻性随机对照研究。收集2019年4至6月郑州市第二人民医院湿性AMD 79例(79眼)随机分为两组。阿柏西普组,39例(39眼),玻璃体内注射阿柏西普;雷珠单抗组,40例(40眼),玻璃体内注射雷珠单抗。术后6个月及12个月...     

The Effect of Bevacizumab versus Ranibizumab in the Treatment of Corneal Neovascularization: A Preliminary Study

Purpose

To compare the short term effects of bevacizumab and ranibizumab injections on the regression of corneal neovascularization (NV).

Methods

Sixteen eyes of 16 patients with corneal NV were randomly assigned for an injection with 2.5 mg of bevacizumab (group 1, n = 8) or 1 mg of ranibizumab (group 2, n = 8) through subconjunctival and intrastromal routes. The patients were prospectively followed-up for one month after the injections. Corneal NV areas, as shown on corneal slit-lamp photographs stored in JPEG format, were calculated using Image J software before the injection, one week after the injection, and one month after the injection. The corneal NV areas were compared before and after the injections.

Results

Seven women and nine men, with an average age of 51 years, presented with corneal NV secondary to herpetic keratitis (7 cases), graft rejection (6), chemical burn (1), pemphigoid (1), and recurrent ulcer (1). In group I, the preoperative corneal NV area (8.75 ± 4.33%) was significantly decreased to 5.62 ± 3.86% one week after the injection and to 6.35 ± 3.02% one month after the injection (p = 0.012, 0.012, respectively). The corneal NV area in group 2 also exhibited a significant change, from 7.37 ± 4.33% to 6.72 ± 4.16% one week after the injection (p = 0.012). However, no significant change was observed one month after the injection. The mean decrease in corneal NV area one month after injection in group 1 (28.4 ± 9.01%) was significantly higher than in group 2 (4.51 ± 11.64%, p = 0.001).

Conclusions

Bevacizumab injection resulted in a more effective and stable regression of corneal NV compared to the ranibizumab injection. The potency and dose of these two drugs for the regression of corneal NV require further investigation.     

Ranibizumab for idiopathic epiretinal membranes: A retrospective case series

PurposeTo study the effect of intravitreal ranibizumab on idiopathic epiretinal membranes (ERMs).MethodsA retrospective cohort study on a consecutive series of ranibizumab intravitreal injections for epiretinal membranes was performed. Four cases were identified by reviewing a claims database linked to electronic medical records. All patients received a total of three 0.05 mg/0.05 ml ranibizumab intravitreal injections at a monthly interval. The primary outcome measure was the final best-corrected visual acuity (BCVA) at the end of the injection series, and the final central macular thickness (CMT).ResultsAll four patients completed 3 months follow-up after the last ranibizumab injection. The mean baseline CMT was 509 microns (SD = 111). A trend was noticed for reduction in CMT (Δ = 41 microns) P = 0.08. Three patients improved by one line in their BCVA. The remaining patient maintained the same BCVA. No complications were noted.ConclusionIn this study, intravitreal injection of ranibizumab marginally reduced retinal thickness in four patients with minimal improvement in visual acuity. No safety concerns were noticed. Further basic science and clinical studies may be warranted to assess the role of vascular endothelial growth factor and the effect of ranibizumab on idiopathic epiretinal membranes.     

泡沫硬化剂治疗下肢网状静脉扩张

目的探讨泡沫硬化剂治疗下肢网状静脉曲张的近期疗效。方法 2010年1-9月在我院诊断为网状静脉扩张症的患者26例,女性24例,男性2例,平均年龄37（22-52）岁,44患肢,局部直接注射泡沫硬化剂后弹力袜压迫,72h、7d、30d、3个月病房随访。结果 26例患者平均治疗2.1次,末次注射结束后72h观察网状静脉扩张闭合成功率达100%,术后7d、30d观察治疗效果牢固,无复发病例。术后3个月7例（9患肢）局部复发,复发率20.5%,局部泡沫硬化剂处理后至今未复发。100%的患者临床症状得到不同程度的缓解。结论泡沫硬化剂治疗网状静脉曲张近期疗效确切。     

雷珠单抗治疗白内障术后黄斑囊样水肿的效果

目的 探讨玻璃体腔注射雷珠单抗治疗白内障术后人工晶体眼黄斑囊样水肿(PCME)的有效性和安全性.方法 对5例局部激素和非甾体类消炎药治疗无效的PCME患者采用玻璃体腔注射雷珠单抗治疗.比较治疗前后最佳矫正视力(BCVA)和中央视网膜厚度(CRT).结果 与治疗前比较,治疗后BCVA和CRT均改善[0.18±0.06 vs.0.62±0.11和(730.80±42.66) μmvs.(245.80±18.54) μm](P＜0.01).随访5-12个月,未见复发,亦无局部和全身不良反应.结论 玻璃体腔注射雷珠单抗是一种安全有效的治疗PCME的方法.     

Comparison of intravitreal ranibizumab between phakic and pseudophakic neovascular age-related macular degeneration patients: Two-year results

Background and objective

To compare the efficacy of intravitreal ranibizumab (IVR) for the treatment of neovascular age-related macular degeneration (nAMD) between phakic and pseudophakic eyes after a follow-up of two years.

Materials and methods

Data were analyzed retrospectively. The newly diagnosed and treatment naïve nAMD patients were included in the study. The patients were divided into two subgroups: phakic group, and pseudophakic. All patients received 3 consecutive monthly IVR injections, and then the treatment was continued on an as-needed regimen. Patients were examined monthly, and the data at the baseline, at month 6, 12, 18, and 24 were evaluated. The changes in best corrected visual acuity (BCVA), central retinal thickness (CRT), and the number of injections were compared between the two groups.

Results

The study included 92 eyes of 87 patients (58 phakic, 34 pseudophakic). Mean logarithm of the minimal angle of resolution (LogMAR) VA at the baseline, and at month 6, 12, 18, and 24 was 0.89, 0.74, 0.75, 0.73, and 0.75, in the phakic group; and 0.79, 0.71, 0.66, 0.70, and 0.70 in the pseudophakic group, respectively. The change in mean BCVA from the baseline to month 6, 12, 18, and 24 was not statistically different between the two groups (p = 0.4, p = 0.9, p = 0.5, p = 0.6, respectively). Mean injection number at month 24 was 7.9 and 8.1 in the phakic and pseudophakic group, respectively (p = 0.7).

Conclusion

Intravitreal ranibizumab treatment on an as-needed treatment regimen is effective in preserving vision and improving central retinal thickness in both the phakic and pseudophakic group of nAMD patients. The functional and anatomical outcomes of the treatment, and the number of injections were similar in the phakic and pseudophakic nAMD patients after a follow-up time of 24 months.     

Assessment of Patient Pain Experience during Intravitreal 27-Gauge Bevacizumab and 30-Gauge Ranibizumab Injection

PurposeTo compare pain scores of patients during intravitreal 27-gauge bevacizumab and 30-gauge ranibizumab injection procedures.MethodsSeventy eyes of 70 patients who had not previously undergone intravitreal anti-vascular endothelial growth factor therapy were included in this study. Thirty-five patients received ranibizumab and 35 patients received bevacizumab. The diagnoses of the patients were: 27 age related macular degeneration, 15 diabetic macular edema, 9 diabetic vitreous hemorrhage, 6 central retinal vein occlusion, 11 branch retinal vein occlusion and 2 central serous chorioretinopathy. Bevacizumab (1.25 mg/0.05 mL) was injected into the vitreous cavity using a 27-gauge needle, and ranibizumab (0.5 mg/0.05 mL) was injected with 30-gauge needle. Patients were asked just after the injection to rate their perceived pain during the injection using the visual analogue scale (VAS) of 0 (no pain) to 10 (unbearable/worst pain). The average of these scores was used as the primary outcome.ResultsThe VAS pain scores in the ranibizumab and bevacizumab groups were 1.06 ± 0.91 (range, 0 to 3) and 1.94 ± 1.55 (range, 0 to 7), respectively, a significant difference (p = 0.005). Patients <65 and ≥65 years of age in both the ranibizumab and bevacizumab groups were then compared. For patients <65, there was a significant difference in the average VAS pain scores between groups (p = 0.003). However, for patients ≥65 years, there was not a significant difference in the average VAS pain scores between groups (p = 0.238). Female and male patients in both ranibizumab and bevacizumab groups were also compared. For female patients, there was a significant difference in the average VAS pain scores between groups (p = 0.016), although not for male patients (p = 0.078).ConclusionsThirty-gauge intravitreal injection is more comfortable than 27-gauge injection. Injection of bevacizumab with 30-gauge needle syringes may be more tolerable for patients.     

尿激酶联合雷珠单抗及氩激光治疗视网膜分支静脉阻塞继发黄斑水肿患者的观察

目的:探讨尿激酶联合雷珠单抗(Ranibizumab)及氩激光治疗视网膜分支静脉阻塞(ranch retinal vein occlusion,BRVO)继发黄斑水肿患者的效果。方法:12例(12只眼)BRVO继发黄斑水肿患者接受尿激酶10万单位静脉滴注联合玻璃体腔内注射雷珠单抗0.05 ml/(0.5 mg)及氩激光局部视网膜光凝,术后2周及4周后随访,对比治疗前后患者的最佳矫正视力(best-corrected visual acuity,BCVA)及黄斑中心凹厚度(central macular thickness,CMT)。结果:治疗前患者的最佳矫正视力为0.15±0.11,平均黄斑中心凹厚度为(565±113)μm,治疗后2周及4周患者的最佳矫正视力分别为0.36±0.16(P=0.034),0.56±0.12(P=0.032);治疗后2周及4周患者的平均黄斑中心凹厚度为(315±89)μm(P=0.039),(255±50)μm(P=0.008)。结论:尿激酶联合雷珠单抗及氩激光治疗BRVO继发黄斑水肿,可以使患者的视力明显提高,促进黄斑水肿吸收。     

Clinical efficacy and safety of Razumab® (CESAR) study: Our experience with the world's first biosimilar Ranibizumab

Purpose:The aim of this study was to evaluate the efficacy and safety of Razumab (the biosimilar Ranibizumab by Intas Pharmaceuticals Ltd.) for the treatment of chorioretinal vascular diseases such as diabetic macular edema (DME), choroidal neovascular membrane (CNVM), and macular edema secondary to retinal vein occlusion (RVO).Methods:We conducted a single-center, retrospective study, including patients with DME, CNVM, and RVO, who had received treatment with Razumab® between October 2018 and September 2019. Primary outcome measures were the changes in corrected distance visual acuity (CDVA) and central foveal thickness (CFT) from baseline to 1 month and 3 months. Secondary outcome measures included intraocular pressure (IOP) at day 1, any signs of ocular inflammation or systemic adverse events during the follow-up.Results:One hundred and fifty-three eyes of 141 patients were analyzed. The indications included DME in 70 (45.8%) eyes, CNVM in 70 (45.8%) eyes, and RVO in 13 (8.4%) eyes. Mean CDVA improved from baseline (0.62 ± 0.44) to month 1 (0.45 ± 0.42) and maintained till 3 months (0.42 ± 0.44; P < 0.001). Mean CFT showed significant reduction from baseline (405.68 ± 192.422 μm) to month 1 (286.08 ± 118.36 μm) and month 3 (271 ± 104.24 μm; P < 0.001). None of the eyes recorded IOP >20 mmHg on day 1. No evidence of ocular toxicity or systemic adverse event was noted.Conclusion:Razumab® showed a rapid improvement in CDVA and CFT in most of the eyes with efficacy observed as early as 1 month and maintained till 3 months. The biosimilar Ranibizumab can be a safe and effective low-cost drug for treating macular diseases.     

雷珠单抗治疗伴或不伴视网膜前出血的ROP的疗效观察

目的:对比研究玻璃体腔注射雷珠单抗治疗伴或不伴视网膜前出血(PRH)的早产儿视网膜病变(ROP)的疗效。方法:收集2017-04/2018-01在本院行玻璃体腔注射雷珠单抗治疗的ROP患儿34例66眼进行回顾性分析研究。将所有患儿按照有无PRH分成两组:ROP伴PRH组26眼与ROP不伴PRH组40眼。所有患儿均在表面麻醉下行玻璃体腔注射雷珠单抗,对患儿术后情况进行观察,分析两组患儿的一次治愈及需要二次治疗情况。结果:经过首次玻璃体腔注射雷珠单抗治疗后随访至12mo,ROP伴PRH组和ROP不伴PRH组患儿一次治愈构成比分别为65%(17眼)和98%(39眼),需要二次治疗的构成比分别为35%(9眼)和2%(1眼)。需要二次治疗病例经过二次玻璃体腔注射雷珠单抗药物治疗,均全部治愈。两组间的一次治愈构成比有差异(P<0.05)。结论:玻璃体腔注射雷珠单抗治疗伴PRH的ROP的一次治愈效果明显低于不伴PRH的ROP的患儿,需要二次治疗病例经过再次玻璃体腔注射雷珠单抗治疗可以得到治愈。