摘要目的：观察探讨玻璃体腔注射雷珠单抗治疗渗出型老年性黄斑变性（AMD）患眼随访2年终末视力与基线特征的相关性。方法回顾性研究。临床确诊为渗出型AMD的44例患者44只眼纳入研究。患者中，男性19例，女性25例。年龄64～92岁，平均年龄78岁。所有患者均采用早期治疗糖尿病视网膜病变研究视力表检测最佳矫正视力（BCVA），同时行眼底彩色照相、荧光素眼底血管造影（FFA）、吲哚青绿血管造影（ICGA）和光相干断层扫描（OCT）检查。患眼平均BCVA为（50.36±14.43）个字母数，平均黄斑中心凹视网膜厚度（CFT）为（291.95±82.19）μm，脉络膜新生血管（CNV）平均荧光素渗漏面积为（7.61±5.84）mm2。所有患眼均采用每一个月注射1次、连续注射3个月后按需治疗的方案行玻璃体腔注射雷珠单抗治疗。治疗后随访时间24～29个月，平均随访时间25.6个月。治疗后1、2、3、6、12、18、24个月重复行BCVA及OCT检查；治疗后3、6、12、18、24个月重复行FFA及ICGA检查。对比观察治疗前后BCVA、CFT及CNV荧光素渗漏面积的变化。分析随访2年终末BCVA与基线BCVA、CFT及CNV荧光素渗漏面积的相关性。结果治疗后1、2、3、6、12、18、24个月患眼平均BCVA均较治疗前有不同程度提高，差异有统计学意义（t=?1.89、?3.51、?4.61、?4.04、?5.77、?4.69，P＜0.05）；CFT较治疗前有不同程度下降，差异均有统计学意义（t=1.51、2.30、3.40、3.28、3.54、3.88、3.73，P＜0.05）。治疗后3、6、12、18、24个月患眼CNV平均荧光素渗漏面积较治疗前均有不同程度减小，差异均有统计学意义（t=2.12、2.90、3.51、4.12、4.06，P＜0.05）。相关性分析结果显示，治疗前BCVA越差，治疗后BCVA提高越多。随访终末BCVA的提高程度与治疗前BCVA、CNV荧光素渗漏面积均呈负相关（r=0.505、?0.550，P＜0.05）；与治疗前CFT无相关性（r=0.210，P＞0.05）。结论玻璃体腔注射雷珠单抗治疗渗出型AMD患眼随访2年终末视力与治疗前基线视力及CNV荧光素渗漏面积有相关性，与治疗前CFT无相关性。

abstractsObjective To observe the baseline characteristics and visual outcomes after two years follow-up of exudative age-related macular degeneration (AMD) patients treated with ranibizumb. Methods Forty-four eyes of 44 patients with exudative AMD were enrolled into this retrospective study, 19 were men and 25 were women. The mean age was 78 years (range 64–92 years). All patients were underwent best corrected visual acuity (BCVA, Early Treatment of Diabetic Retinopathy Study), fundus color photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). The mean BCVA was (50.36±14.43) letters, the mean central foveal thickness (CFT) was (291.95± 82.19)μm, and the fluorescence leakage area of choroidal neovascularization (CNV) was (7.61±5.84) mm2. All&nbsp;patients received three initial intravitreous injection of ranibizumb (IVR) and were retreated with monthly IVR when needed. The mean follow up time was 25.6 months (range 24–29 months). On 1, 2, 3, 6, 12, 18 and 24 months after treatment, BCVA and OCT were repeated. On 3, 6, 12, 18 and 24 months after treatment, FFA and ICGA were repeated. The change of BCVA, CFT and fluorescence leakage area of CNV were observed. The association of baseline characteristics and two year visual outcomes were analyzed. Results On 1, 2, 3, 6, 12, 18 and 24 months after treatment, the BCVA were improved significantly (t=?1.89,?3.51,?4.61,?4.04,?5.77,?4.69;P<0.05), the CFT were decreased significantly (t=1.51, 2.30, 3.40, 3.28, 3.54, 3.88, 3.73;P<0.05). On 3, 6, 12, 18 and 24 months after treatment, the fluorescence leakage area of CNV were reduced significantly (t=2.12, 2.90, 3.51, 4.12, 4.06;P<0.05). The lower baseline BCVA, the more improved after treatment. The BCVA improvement degree has a negative relationship with baseline BCVA and fluorescence leakage area of CNV (r=0.505,?0.550;P<0.05), but no correlation with baseline CFT (r=0.210, P>0.05). Conclusion Two year visual outcomes of exudative AMD patients treated with ranibizumb is negative correlated with baseline BCVA and fluorescence leakage area of CNV, but not correlated with baseline CFT.