摘要
年龄相关性黄斑变性（AMD）可导致严重的视力丧失，脉络膜新生血管（CNV）是其主要的致盲原因，血管内皮生长因子（VEGF）在CNV的形成过程中起着至关重要的作用。Ranibizumab是一种重组的人源化抗VEGF单克隆抗体片段，能够抑制新生血管形成，减少血管渗漏。国内外多项研究证实玻璃体腔内注射ranibizumab治疗湿性AMD具有一定的疗效，为ranibizumab的临床应用提供了高等级的临床试验证据。Ranibizumab治疗湿性AMD的最佳时机为治疗的起始阶段，其最佳治疗方案为每月注射1次，连续3个月，之后每月注射1次进行维持治疗。维持期的治疗应每月监测病情的动态变化，光学相干断层扫描（OCT）、荧光素眼底血管造影（FFA）、视力等是主要的检测指标，对调整治疗方案起指导作用。维持阶段也可采取个体化治疗或与光动力疗法（PDT）的联合疗法，以适当减少注射次数和频率。系统检索和总结ranibizumab治疗湿性AMD的文献资料．可从循证医学的角度为ranibizumab的临床应用提供证据支持。
Age-related macular degeneration （AMD） causes severe vision loss due to the development of choroidal neovaseularization （ CNV）. The critical role of VEGF in the pathogenesis of CNV is well understood and known. Ranibizumab is a fragment of a humanized monoclonal antibody. It plays an inhibitory role on CNV and reduces vascular permeability by binding to VEGF. Some clinical trials and literature have proved the clinical efficacy of ranibizumab via intravitreal injection for wet AMD. But the systematized administration is vital important. Some high-quality researches showed that the optimal timing for ranibizumab treating wet AMD is the first 3 months. It is recommended that ranibizumab is intravitreally injected monthly in the initiation for least 3 months. Sequent managing regimen should be made depended on the image of optical coherence topography and fundus fluorescine angiograpby and visual acuity change. Individuated strategy or combined method with PDT are beneficial to the active lesion in the consecutive treatment of ranibizumab for CNV and may be a good choice in order to decrease the injection times. This article systematically searched and summarized the relative literature and offered the high-quality evidences for the clinical evaluation of ranibizumab treating wet AMD.
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2011年第10期941-945,共5页
Chinese Journal Of Experimental Ophthalmology
