Neovaskulinės amžinės geltonosios dėmės degeneracijos gydymo ranibizumabu 24 mėnesių morfologiniai ir funkciniai pokyčiai

Abstract

abstract:Key words: ranibizumab, age-related macular degeneration, central macular thickness. Research objective. To evaluate influence of treatment with vascular endothelial growth factor inhibitor, ranibizumab, for best corrected visual acuity and central macular thickness in patients with neovascular age-related macular degeneration. Materials and methods. In this retrospective study were included treatment -naive patients. Intravitreal injections were performed at Lithuanian University of Health Sciences Kaunas Clinics Eye clinic. In this study were analysed the 24-month morphological and functional outcomes of intravitreal ranibizumab injections. Best corrected visual acuity was meassured using the Snellen chart (Landolt's rings C optotypes). Optical coherence tomography images were obtained using the spectral -domain OCT (NIDEK RS -3000 Advance (NIDEK CO LTD, Japan). The central thickness measurements were obtained from macular thickness maps using the digital caliper tool. Results. In this study were included 88 patients. Best corrected visual acuity before treatment was 0.36 ± 0.22. The difference between visual acuity before and after first injection was 0.04 ± 0.22 (p = 0.03). Before fifth injection visual acuity was 0.41 ± 0.21, after -0.46 ± 0.22 (p = 0.05). Central macular thickness before treatment was 297.81 ± 106.04 µm. The difference between central macular thickness before and after first injection was 85.21 ± 113.37 µm (p < 0.001). Before second injection central macular thickness was 273.57 ± 87.49 µm, after -234.51 ± 58.96 µm (p = 0.002). Before fourth injection central macular thickness was 237.20 ± 40.87 µm, after -219.10 ± 42.26 µm (p = 0.04). The mean central macular thickness significantly decreased from 298.15 ± 104.78 to 229.08 ± 56.57 (p < 0.001). In 24 month of treatment the average number of ranibizumab injections was 3.61 ± 1.55. Conclusions. Our study's results showed that over 24 month best corrected visual acuity improvement was statistically significant after first and fifth injection. Baseline compared with last injection, there was not statistically significant difference. Central macular thickness improvement statistically significant was after first, second and fourth injection. There was statistically significant decreased baseline compared with the last injection. The mean number of ranibizumab injections was 3.61 ± 1.55 in 24 month. INTRODUCTIONAge-related macular degeneration (AMD) is the prevalent cause of moderate and severe vision loss in developed countries and the third major cause of blindness worldwide [1]. AMD is a disorder of unknown cause and pathogenesis causing decrease or loss of the ability to read in the elderly age-group and affecting about 180 million people all over