ObjectiveTo observe the efficacy and safety of combined photodynamic therapy (PDT) with intravitreal ranibizumab injection in patients with polypoidal choroidal vasculopathy (PCV). MethodsTwenty-four PCV patients (24 eyes) were enrolled in this retrospective case study.All patients were assessed by the examinations of Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart, color fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optic coherence tomography (OCT). The mean visual acuity was (33.41±19.43) letters; the mean macular retinal thickness was (343.63±88.60) μm. Patients received PDT first, and intravitreal injected ranibizumab 0.5 mg (0.05 ml) 72 hours later. Treatments were repeated as a single intravitreal injection of ranibizumab combined with or without PDT if the monthly follow-up indicated that it was necessary. The average follow-up period was 13.1 months. The average treatment times were analyzed for each eye. Systemic and ocular adverse events were observed. Visual acuity, macular retinal thickness and leakage of PCV before and after the treatment were analyzed. ResultsIntravitreal ranibizumab injections was repeated (2.8±1.6) times per eye on average, and intravitreal injection of ranibizumab combined with PDT was repeated (0.4±0.5) times per eye on average. No systemic and ocular adverse effects were found during and after combined therapy. In the last follow-up, the mean visual acuity of ETDRS was (44.21±17.24) letters, improved by 10.8 letters (t=-4.77, P<0.01).Visual acuity was improved in 11 eyes (45.8%) and stable in 13 eyes (54.2%). FFA and ICGA showed complete closed PCV in 17 eyes (70.8%), partial closed PCV in 7 eyes (29.2%). OCT image showed that the retinal edema was disappeared in 19 eyes (79.2%) and alleviated in 5 eyes (20.8%). The mean macular retinal thickness was (171.33±38.06) μm, which was 172.30 μm less than that of pre-treatment values (t=11.96, P<0.05). ConclusionPhotodynamic therapy combined with intravitreal ranibizumab injections for PCV is safe and effective, with visual acuity improvement, reduction of retinal edema and PCV leakage.
Objective To observe the efficacy and safety of intravitreal injection of ranibizumab (Lucentis) to treat idiopathic choroidal neovascularization（ICNV）. Methods Fifty-four eyes from 54 patients with ICNV were included in this study. There were 24 males and 30 females. The patients aged from 21 to 49 years with a mean age of 32.57plusmn;7.06 years. The course of disease ranged from 6 days to 3 months with an average of 1.07plusmn;0.65 months. The examinations of best corrected visual acuity (BCVA) included Snellen chart and ETDRS visual acuity of ETDRS chart. Indirect ophthalmoscopy, fundus fluorescein angiography (FFA) and optic coherence tomography (OCT) were performed. The BCVA was hand motion 0.6. The average score of ETDRS chart was 32.00plusmn;16.41, and the average CRT (337.31plusmn;76.91) mu;m before treatment. All of the patients received an initial intravitreal injection of ranibizumab (0.5 mg,0.05 ml) and repeated treatments after the one-month follow-up if needed. The average follow-up period was 15.56plusmn;6.54 months. The changes of BCVA, ETDRS visual acuity, CRT and leakage of CNV before and after treatment were observed. Results One month after first injection, the mean number of ETDRS chart letters increased 16.81 to 48.81plusmn;16.96 with a significant difference (t=-11.991,P＜0.01), in which 25 eyes increased more than 15 (46.30 %), while 2 eyes decreased more than 1 (3.70%). The mean CRT was (227.67plusmn;91.41) mu;m, which significantly decreased compared with before treatment (t=12.021,P＜0.01). At the end of the follow-up period the number of repetitive intravitreal injections of ranibizumab was 1-4 times, with the mean of (1.59plusmn;0.71) times/eye. The mean number of ETDRS chart letters increased 17.20 to 49.20plusmn;16.60 with a significant difference (t=-11.390,P＜0.01), in which 27 eyes increased more than 15 (50.00%), while 3 eyes decreased more than 1 (5.56%). The mean CRT was (227.69plusmn;89.30) mu;m, which significantly decreased compared with before treatment (t=10.872,P＜0.01). There was complete CNV closure in 35 eyes (64.81％)，partial closure in 11 eyes (20.37％)，no change or expansion in 6 eyes (11.11％), and new CNV in 2 eyes (3.70％). No ocular or systemic adverse events were found after intravitreal injection of ranibizumab during the follow-up duration. Conclusions Intravitreal injection of ranibizumab is safe and effective for idiopathic choroidal neovascularization. It may improve the visual acuity and macular edema. However,long-term efficacy and safety remain to be further studied.
Objective To observe the clinical efficacy of intravitreal Ranibizumab on exudative agerelated macular degeneration (AMD).Methods The clinical data of 46 patients（52 eyes）with exudative AMD were analyzed retrospectively. All patients were diagnosed by examination of early treatment of diabetic retinopathy study (ETDRS) charts, color fundus photograph，fluorescein angiography（FFA）or indocyanine green angiography（ICGA）and optical coherence tomography（OCT）.They received intravitreal injection of 0.05 ml (10 mg/ml) Ranibizumab, once per month for 3 months. Further injection may be required if the monthly followup indicated. A total of 52 eyes received 214 times of injections, each eye received 2-6 injections (mean 4.12). The Followup duration was 12 months. Vision acuity, fovea thickness and CNV leakage before and after treatment were analyzed.Results At the 12th month after treatment, the mean letter of ETDRS charts was 37.80 (11.40 letters more that pretreatment index,Plt;0.01). FFA and (or) ICGA showed complete closures choroidal neovascularization (CNV) in 11 eyes（21.20%），partial closures in 34 eyes (65.40%)，no change in four eyes (7.70%)，lesion growth in two eyes（3.80%）and new lesion in one eye (1.90%).OCT indicated the average of fovea thickness was 187.50 mu;m (122.80 mu;m less than the pretreatment index, Plt;0.01).Conclusion Intravitreal injection of Ranibizumab for exudative AMD according to this therapeutic schedule was well tolerated，with an improvement in visual acuity，FFA or ICGA and OCT.