摘要目的 观察玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab(商品名:Lucentis)治疗病理性近视脉络膜新生血管(CNV)的临床疗效.方法 前瞻、无对照、开放性研究.病理性近视CNV患者34例34只眼纳入研究.采用国际标准视力表、糖尿病视网膜病变早期治疗研究(ETDRS)视力表测量矫正视力,同时行眼压、检眼镜、眼底照相、荧光素眼底血管造影(FFA)及光相干断层扫描(OCT)检查.治疗前患眼EDTRS视力表视力0～69个字母,平均视力(33.85±14.67)个字母;黄斑中心凹视网膜厚度(CMT)210～543 μm,平均CMT(293.41±79.45) μm.所有患眼玻璃体腔注射10 mg/ml的ranibizumab0.05 ml(含ranibizumab 0.5 mg).治疗后每1个月随访1次.随访3～12个月,中位数7个月.对比分析治疗前后矫正视力及CMT变化情况.结果 所有患眼平均玻璃体腔注射1.68次.末次随访时,平均矫正视力较治疗前提高(13.50±9.94)个字母,差异有统计学意义(t=7.92,P=0.00);CMT降低(71.14±72.26) μm,差异有统计学意义(t=4.62,P=0.00).随访期间未发现与治疗相关的全身及眼部严重并发症.结论 玻璃体腔注射ranibizumab治疗病理性近视CNV视力预后较好,病灶水肿消退明显,安全性高.

abstractsObjective To evaluate the clinical efficacy of intravitreal injections of anti-vascular endothelial growth factor monoclonal antibody ranibizumab in choroidal neovascularization (CNV) secondary to pathologic myopia (PM).Methods This is a prospective,uncontrolled,open-label study.34 eyes of 34 patients with CNV secondary to PM were included in the study.All affected eye were treated with intravitreal ranibizumab 0.05 ml (10 mg/ml).Before the injection,best-corrected visual acuity of early treatment of diabetic retinopathy study (ETDRS),non-contact tonometer,ophthalmoscope,fundus photography,fundus fluorescein angiograph (FFA) and optical coherence tomography (OCT) examination were necessary.The initial average letters of ETDRS acuity were 33.85 ± 14.67,range from 0 to 69.The initial average central macular thickness (CMT) was(293..41±79.45) m,range from 210 m to 543 m.The patients were followed up for 3 to 12 months.Best-corrected visual acuity,OCT and ophthalmoscope examination were assessed monthly.If necessary,FFA was used.The letters of ETDRS acuity and CMT were compared before and after treatment.Results All eyes received an average of 1.68 injections,the final vision of follow-up increased (13.50 ± 9.94) letters than before (t =7.92,P =0.00),CMT decreased (71.14±72.26) m (t=4.62,P=0.00).There were no systemic or ocular serious side effects during the follow up.Conclusion Intravitreal ranibizumab for pathologic myopia choroidal neovascularization showed visual acuity improvement,retinal thickness reduction and safety.