雷珠单抗联合光动力疗法治疗湿性年龄相关性 黄斑变性的黄斑形态学变化分析

Morphological analysis of macula in wet age-related macular degeneration after treatment of Ranibizumab combined with PDT

摘要:

目的 分析雷珠单抗联合光动力疗法（PDT）治疗湿性年龄相关性黄斑变性的黄斑形态学变化。方 法 收集湿性年龄相关性黄斑变性患者57 例（1 眼/ 例）并分为观察组30 例（雷珠单抗联合光动力疗法）和对 照组27 例（雷珠单抗单药治疗）。比较两组治疗后黄斑形态学的变化。结果 治疗后黄斑中心凹厚度（CMT） 及病变面积均呈下降趋势（P <0.05），观察组下降幅度高于对照组。治疗后1 个月下降幅度最大，观察组和对照 组CMT 下降幅度分别为（87.5±12.8）和（60.1±16.6）μm ；观察组和对照组黄斑病变面积减少幅度分别 为（2.5±0.6）和（1.8±0.7）mm2。治疗后12 个月观察组和对照组黄斑病变面积减少有效率分别为93.3% 和 77.8%。结论 与单药治疗相比，雷珠单抗联合光动力疗法更能提高黄斑形态学改善的效果。

Abstract:

Objective To retrospectively analyze morphological change of macula in wet age-related macular degeneration (wAMD) after treatment of Ranibizumab combined with photodynamic therapy (PDT). Methods Fifty-seven patients (57 eyes) with wAMD were assigned to observed group (30 eyes) with the regimen of Ranibizumab combined with PDT and control group (27 eyes) with Ranibizumab monotherapy. The change of macular morphology including the central macular thickness (CMT) and area of lesion (AOL) in macular between the two groups werecompared. Results After treatment, both CMT and AOL decreased over time compared with the baseline (P < 0.05). The declines of CMT and AOL in the observed group were more marked than control group (P < 0.05). The declines of CMT and AOL were maximal at the first month after therapy. The decline of CMT was (87.5 ± 12.8) μm in the observed group and (60.1 ± 16.6) μm in control group. The decline of AOL was (2.5 ± 0.6) mm2 in observation group and (1.8 ± 0.7) mm2 in control group. At the twelfth month of follow-up, the effective rate of the improvement of AOL in the observed group (93.3%) was higher than the control group (77.8%) (P < 0.05). Conclusions Compared with the monotherapy, Ranibizumab combined with PDT towards wAMD is more effective in the improvement of macular morphology.