雷珠单抗治疗息肉状脉络膜血管病变的疗效观察

目的：比较玻璃体腔内注射雷珠单抗在不同类型的息肉状脉络膜血管病变治疗中的临床疗效。
　　方法：选取2013-05/2015-05在绍兴市人民医院治疗的63例63眼息肉状脉络膜血管病变患者作为研究对象,根据息肉数的差异分为单息肉组(38例38眼)和多息肉组(25例25眼),两组患者均接受玻璃体腔内注射雷珠单抗治疗,每月1次,连续注射3mo。注射后随访1a,比较两组患者治疗后最佳矫正视力( best corrected visual acuity, BCVA)和中心视网膜厚度( central retinal thickness,CRT)的变化。
　　结果：与多息肉组比较,单息肉组治疗前最大线性直径更大、纤维血管性视网膜色素上皮脱离发生率更低、BCVA更低(P<0.05)。治疗后3、6mo,1a单息肉组BCVA明显低于多息肉组(P<0.05)；单息肉组治疗后3、6mo,1a时BCVA较治疗前均显著下降( P<0.05)。单息肉组和多息肉组患者的CRT在治疗后6、12mo有统计学差异(P<0.05)；单息肉组治疗后3、6mo,1a时CRT均较治疗前低( P<0.05),多息肉组治疗后3、6 mo的CRT较治疗前低( P<0.05)。结论：玻璃体腔内注射雷珠单抗在多息肉型息肉状脉络膜血管病变中治疗效果更好,息肉数量对于评估预后具有重要意义。

Effect of intravitreal Ranibizumab treatment in polypoidal choroidal vasculopathy with different types

AIM: To investigate the efficiency of intravitreal ranibizumab therapy(IVR)for polypoidal choroidal vasculopathy(PCV)in single or multiple polyps.

METHODS: A total 63 patients diagnosed with PCV in Shaoxing City People''s Hospital from May 2013 to May 2015 were enrolled and divided into single polyp group and multiple polyps group. All patients received intravitreal ranibizumab 3 monthly and were followed up for 12mo. Observe the changes of best corrected visual acuity(BCVA)and central retinal thickness(CRT)at different time points.

RESULTS: The single polyps group exhibited a better BCVA, shorter greatest linear dimension, and lower prevalence of fibro-vascular pigment epithelial detachment compared with the multiple polyp group before treatment(P<0.05). Significant difference of BCVA were observed at 3, 6 and 12mo between the two groups(P<0.05). BCVA at 3, 6, 12mo was significantly better than that at baseline in single polyps group. The single polyp group exhibited a significantly thinner CRT at 6 and 12mo compared with multiple polyps group(P<0.05). The single polyp group showed improvement in CRT over the followed up period(P<0.05). The CRT in multiple polyps group at 3 and 6mo significantly decreased compared with preoperative(P<0.05).

CONCLUSION: IVR meet better result in PCV patients with multiple polyp and polyp numbers may be valuable to prognosis.