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find Keyword "单克隆/治疗应用" 102 results
  • Development, problems and prospects of the treatment of diabetic macular edema

    Diabetic macular edema (DME) is a common ocular complication of diabetes patients. It mainly involve macular which is closely related with visual function, thus DME is one of the major reasons causing visual impairment or blindness for diabetes patients. How to reduce the visual damage of DME is always a big challenge in the ophthalmic practice. In the past three decades, there are tremendous developments in DME treatments, from laser photocoagulation, antiinflammation drugs to antivascular endothelial growth factor therapy. However, the mechanism of DME development is not yet completely clear; every existing treatment has its own advantages and weaknesses. Therefore DME treatment still challenges us to explore further to reduce the DME damages.

    Release date:2016-09-02 05:18 Export PDF Favorites Scan
  • Effects of dual targets intervention on the expression of vascular endothelial growth factor and connective tissue growth factor in diabetic rat retina

    Objective To observe the effects of dual targets intervention on the expression of vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) in diabetic rat retina. Methods Forty-eight Sprague -Dawley rats were randomly divided into control group (CON1 group) and diabetes mellitus group (DM group). The rats of DM group were induced with streptozotocin injection creating a diabetic model. Retinas were obtained at eight, 10, 12 weeks after DM induction from both groups. CTGF and VEGF mRNA levels were examined by realtime reverse transcriptionpolymerase chain reaction (RT-PCR). Based on the results of above experiments, 60 rats with same conditions were selected. Fifty rats were induced with streptozotocin injection creating a diabetic model, and 10 rats comprised the control group (CON2 group). Then the 50 diabetic rats were randomly divided into ranibizumab and CTGF shRNA dual targets intervention group, ranibizumab singletarget intervention group, CTGF shRNA singletarget intervention group and nonintervention group. Retinas were obtained at one week after intervention from all the groups. CTGF and VEGF mRNA levels were examined by RT-PCR. Results The levels of CTGF mRNA were significantly higher in DM group than that in CON1 group at the 8th weeks after DM induction, and this upregulation was maintained through the 12th week (t=-2.49, -2.67, -2.42;P<0.05). There was no difference on VEGF mRNA levels between DM group and CON1 group at the 8th weeks after DM induction(t=-0.443,P=0.669). VEGF mRNA levels of DM group started to be significantly elevated over those in the CON1 group at the 10th week, and remained to be higher at the 12th week (t=-2.35, -2.57;P<0.05). The VEGF mRNA of ranibizumab single-target intervention group was significantly lower than that in non-intervention group (t=-3.44,P=0.014), which was similar to CON2 group (t=-1.37,P>0.05); however, the CTGF mRNA level was significantly increased as compared to the nonintervention group (t=2.48,P<0.05). In the CTGF shRNA single-target intervention group, the levels of CTGF and VEGF mRNA were decreased as compared to the non-intervention group (t=0.23, -2.92;P<0.05). In the ranibizumab and CTGF shRNA dual targets intervention group, the levels of CTGF and VEGF mRNA were decreased as compared to the non-intervention group (t=-6.09, -5.11;P<0.001), which was similar to CON2 group (t=-1.16, 1.139; P>0.05). Conclusions Both CTGF and VEGF gene expression are up-regulated in early diabetic rat retina, and the level of CTGF increased earlier than VEGF. Ranibizumab combined with CTGF shRNA could simultaneously reduce the level of CTGF and VEGF mRNA in diabetic rat retina.

    Release date:2016-09-02 05:18 Export PDF Favorites Scan
  • 雷珠单抗治疗新生血管性老年性黄斑变性的安全性研究

    随着对血管内皮生长因子(VEGF)的深入研究和抗VEGF药物的研发,新生血管性老年性黄斑变性治疗领域有了突破性进展。抗VEGF药物治疗新生血管性老年性黄斑变性的主要途径是玻璃体腔注射。任何一种新兴疗法的应用都要建立在可靠的安全性研究基础上。抗VEGF药物玻璃体腔注射的不良反应主要分为药物相关和注射相关不良反应。其中,眼部不良反应主要有眼内炎、视网膜脱离、视网膜裂孔、眼压升高、白内障等;全身不良反应主要有心肌梗死、卒中、尿路感染、高血压、鼻咽炎、咽痛、前列腺癌、骨关节炎、腹股沟疝等。与贝伐单抗(bevacizumab,商品名Avastin)比较,雷珠单抗(ranibizumab,商品名Lucentis)具有较低的不良反应发生率,其全身不良反应不明显。基于药物的安全性差异还有待于更大规模临床试验来证实。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 影响抗血管内皮生成因子治疗渗出型老年性黄斑变性预后的因素

    玻璃体腔注射抗血管内皮生长因子(VEGF)药物是治疗渗出型老年性黄斑变性(AMD)脉络膜新生血管(CNV)的安全有效方法 。但基线视力、年龄、首发症状、开始治疗的时间、对最初3次治疗的反应以及光相干断层扫描、荧光素眼底血管造影、眼底自身荧光检查结果不同的患者,其治疗预后差异较大;除了上述临床特征和指标外,基因及生物学标记物方面的差异对治疗预后也有影响。探讨影响渗出型AMD患者抗VEGF治疗预后众多相关因素中的主要因素并采取相应的对策,对于提升抗VEGF药物治疗效果具有积极意义。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Effect of photodynamic therapy combined with intravitreal bevacizumab on wet age-related macular degeneration

    Objective To investigate the effect of photodynamic therapy (PDT) combined with intravitreal bevacizumab on wet age-related macular degeneration (AMD). Methods In this retrospective study, 34 eyes (28 cases) diagnosed with wet AMD received PDT combined intravitreal injection of bevacizumab, including 25 eyes with classic CNV and 9 eyes with minimally classic CNV by fluorescein angiography; On optical coherence tomography (OCT), 23 eyes showed intraretinal fluid (IRF) and 11 eyes presented subretinal fluid (SRF). After signing informed consent, all patients underwent initial standard PDT followed by intravitreal bevacizumab (1.25 mg) within succeeding 3 to 7 days. Best corrected visual acuity (BCVA) and OCT with routine eye examinations were evaluated monthly. Additional bevacizumab (1.25 mg) was injected intravitreally if new or increasing fluid appreciated on OCT, or BCVA lowered more than 5 letters even with stabilized fluid. Injection was discontinued if no fluid was showed on OCT (quot;dry macularquot;), or BCVA was stabilized even with fluid after two consecutive injections. BCVA and central retinal thickness (CRT) were analyzed and compared between baseline and 6 month follow-up. The correlation between parameters such as baseline BCVA, greatest linear dimension (GLD), type of CNV, SRF or IRF and posttreatment BCVA will be analyzed. The injection number of bevacizumab and complications were recorded. Results Compared to baseline, BCVA improved (9.4plusmn;10.2) letters and reach 44.9plusmn;21.3 letters (t=5.438,P<0.01) and CRT decreased (184.6plusmn;214.6) mu;m (t=4.810,P<0.01) at 6 month visit. The average of injection number was 1.9plusmn;0.9 (including initial injection of combination therapy). With multiple lineal regression analysis, only baseline BCVA correlated to posttreatment BCVA at 6 month visit (r=0.802.P<0.01). The type of CNV, GLD, SRF or IRF on OCT and CRT at baseline were not associated to post-treatment BCVA (r=0.053, -0.183, 0.139 and 0.053, respectively.P>0.05). BCVA of eyes with SRF (14.7 letters) increased more than eyes with IRF (6.9 letters) on OCT (t=-2.207,P=0.035). The change of BCVA after treatment (t=-0.076), change of CRT (t=-1.028) and number of injections (Z=-1.505) were not different between classic CNV and minimally classic CNV (P>0.05). The change of CRT (t=-0.020) and number of injections (Z=-0.237) did not present difference between SRF and IRF (P>0.05). The change of BCVA (t=1.159) and number of injections (Z=-1.194) were not correlated to whether residual fluid or not at 6 month visit (P>0.05). No severe complications were noticed during follow-up.Conclusion For wet AMD patients, PDT combined intravitreal bevacizumab could improve visual acuity, reduce retinal thickness and control CNV progress in a short-term.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Intravitreal ranibizumab injection combined with or without photodynamic therapy for idiopathic choroidal neovascularization: a comparative efficacy study

    Objective To compare the clinic therapeutic effect of intravitreal ranibizumab injection versus photodynamic therapy (PDT) combined with intravitreal ranibizumab injection for idiopathic choroidal neovascularizatio (ICNV), and to investigate the clinical effect and safety of treatment. Methods A randomized controlled clinical prospective study was performed for 27 patients (27 eyes) diagnosed as ICNV. Fourteen patients were assigned to receive PDT and intravitreal ranibizumab injection (combination roup.n=14); the control group was treated with only intravitreal ranibizumab injection (single group, n=13).The combination group was treated with an intravitreal injection of ranibizumab (0.5 mg/0.05 ml) 1 week after PDT. The bestcorrected visual acuity (BCVA) (logMAR), examination of the ocular fundus, fluorescence fundus angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were performed respectively at 1, 2, 3, 6 and 12 months after treatment. If choroidal neovascularization (CNV) was only partially regressed or the leakage went on during follow-up, those patients were re-injected with ranibizumab. Results After 12 months, the average vision is 0.22plusmn;0.11 in single group, and 0.21plusmn;0.12 in combination group, and the differences were not significant (t=0.187, P=0.853). In single group FFA and ICGA showed completely closed CNV in 10 eyes (77.92%), and almost closed CNV in 3 eyes (23.08%) with obvious reduction of fluorescence leakage. In combination group FFA and ICGA showed completely closed CNV in 12 eyes (85.71%), and almost closed CNV in 2 eyes (14.29%) with obvious reduction of fluorescence leakage; OCT showed the subretinal fluid absorption and reduction of CNV. The average macular retinal thickness (MRT) in single groups is (167.96plusmn;10.69) m, and in combination groups is (171.64plusmn;11.30)m. In single and combination groups MRT decreased significantly at the final follow-up, but no significant differences in both groups (t=-0.887.P=0.389). The average number of intravitreal injection was (1.5plusmn;0.7) in combination group and (2.4plusmn;1.0) in single group (t=2.821,P=0.009). There were no ocular or systemic adverse events observed except for one patient with subconjunctival hemorrhage in the single group.Conclusions Intravitreal ranibizumab injection and PDT combined with intravitreal bevacizumab injection are both effective and safe for the patients with ICNV. The combined therapy can induce CNV regression, fundus hemorrhage and exudation absorption more effectively, and have less recurred CNV and side effects.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Clinical observation of intravitreal ranibizumab for treatment of choroidal neovascularization secondary to pathologic myopia

    Objective 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 33.85plusmn;14.67, range from 0 to 69. The initial average central macular thickness (CMT) was(293.41plusmn;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 (13.50plusmn;9.94) letters than before (t=7.92,P=0.00), CMT decreased (71.14plusmn;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.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • A new project worth further investigation: combined treatment of retinal vascular disease with intravitreal injection of antiangiogenic agents and retinal photocoagulation

    Intravitreal injection of antiangiogenic agents is widely used to treat retinal vascular disease. This therapy can induce regression of neovascular vessels; reduce intraocular inflammation and retinal vascular permeability, and control macular edema. However the action period of these agents is short, and thus this therapy need repeated injections which cause higher operation risk and cost. Retinal laser photocoagulation therapy can close retinal capillary non-perfusion area and neovascular vessels, reduce macular edema caused by vascular leakage. However, as its therapeutic effect is based on the destruction of the retinal tissues in the lesion area, this therapy need longer time to show its effects. When the disease is controlled by this method, it may already induce some structural irreversible damages to the retina, especially the macular. This is why the visual acuity is not satisfactory in some patients, even though the disease get controlled, macular edema gets disappeared and anatomical structure of retina get improved. Properly evaluating all the pros and cons of retinal photocoagulation and intravitreal injection of antiangiogenic agents, will allow us to explore a better way to combine these two therapies to treat retinal vascular diseases.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 视网膜静脉阻塞抗血管内皮生长因子治疗研究进展

    以血管内皮生长因子(VEGF)为特异性靶点的新疗法,较激光光凝、糖皮质激素等传统治疗方法独具优势,有望成为视网膜静脉阻塞继发黄斑水肿(ME)的一线治疗。其代表药物抗VEGF单克隆抗体ranibizumab、bevacizumab、aflibercept均能非特异性阻断VEGF-A全部亚型,通过抗原-抗体结合反应在局部发挥药理作用。已有的大样本、随机对照临床研究初步肯定其兼具疗效性和安全性,但仍存在ME复发、治疗频繁、个体差异、费用高等诸多问题,且治疗相关并发症及风险尚待进一步观察。为此,有关预后研究、联合治疗等方面研究已有展开。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab治疗视网膜静脉阻塞黄斑水肿的研究现状

    玻璃体腔注射抗血管内皮生长因子(VEGF)单克隆抗体ranibizumab(商品名Lucetis) (IVR)治疗视网膜静脉阻塞(RVO)继发黄斑水肿的短期疗效已得到广泛肯定。由于ranibizumab半衰期短,黄斑水肿易复发,需多次注射,增加了患者眼内注射潜在并发症的风险。传统激光光凝治疗是目前治疗RVO黄斑水肿的主要方法,其疗效作用较为持久,相对安全,但对视网膜组织具有一定的破坏作用,对视力改善效果不明显。IVR联合黄斑格栅样激光光凝治疗RVO黄斑水肿相比单纯IVR可减少玻璃体腔反复注射次数,降低眼内注射并发症风险,达到更好的治疗效果,可成为将来治疗的发展趋势。但联合治疗时机的选择以及反复注射存在的潜在危险仍需要大样本的长期前瞻性研究进一步观察验证。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
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