| Purpose:To discuss the short-term clinical therapeutic efficacy and safety of intravitreal Ranibizumab(Lucentis) injection for Proliferative diabetic ratinopathy.Methods: We retrospectively reviewed thirty-one patients(eighteen men, thirteen women) with Proliferative diabetic ratinopathy who were treated at the First Affiliated Hospital of Medical College of Shihezi University between July 2013 and November 2014. The patients’ ages ranged from 37 to80(average, 60.65±18.6 years); cases with seventeen right eyes and forteen left eyes,Giving intravitreal Ranibizumab(Lucentis)injection,divided into continuous injection group(injection once a month,continuous injection three times)and single injection group(only injection once),continuous injection group 16 cases,16 eyes,ten men, six women,cases with nine right eyes and seven left eyes;single injection group 15 cases,15 eyes,eight men, seven women,cases with eight right eyes and seven left eyes;All the rearsh object were proliferative diabetic ratinopathy IV,They were all examined for BCVA,intraocular pressure, FFA and OCT before and after treatment for all the patients,Giving intravitreal Ranibizumab(Lucentis) injection 0.05 ml,After Giving intravitreal Lucentis0.05 ml 1 week, 1, 2, 3months, compared the results before and after treatment of examinations including best-correct acuity(BCVA), intraocular pressure(IOP), central maeular thiekness(CMT),vaseular leakage was deteeted by FFA, the average of Best corrected visual acuity(BCVA), Intraocular Pressure(IOP),Central Macular Thickness(CMT) before and after treatment were use One-sample t-test,Compared two groups of visual acuity, intraocular pressure before and after the treatment, the change of CMT using independent sample t-test and paired t-test, with the level of significance set at P <0.05.Results:1.Two groups of patients with licensed resistant glass body cavity injection increase before vision after the injection,Before intravitreal Ranibizumab(Lucentis) injection the mean of best corrected visual acuity(BCVA)was 0.149±0.164,the mean best corrected visual acuity(BCVA)were 0.368±0.181、0.388±0.206、0.494±0.211、0.392±0.209 after intravitreal Ranibizumab(Lucentis) injectiont for 1w,1m,2m and 3m,compared with before intravitreal Ranibizumab( Lucentis) injection the mean of best corrected visual acuity( BCVA) was significant improved(t=2.521,t=3.733,t=3.941,t=3.692,P=0.014,P=0.000,P=0.000,P=0.000,P < 0.05),there was no significant difference with respect to the increase in the visual acuity between 1w and 1m(P>0.05),the best corrected visual acuity(BCVA)of 1m and 2m was significant increased compared to that of 1w(P<0.05),there was significant difference with respect to the increase in the visual acuity between 1m and 2m 、 2m and 3m( P<0.05),there was no significant difference with respect to the increase in the visual acuity between 1m and 3m(P>0.05),Before intravitreal Ranibizumab(Lucentis) injection the mean of best corrected visual acuity(BCVA)was0.158±0.167 in continuous injection group,the mean best corrected visual acuity( BCVA) were0.382±0.186、0.394±0.216、0.411±0.222、0.328±0.221 after intravitreal Ranibizumab(Lucentis)injectiont for 1w,1m,2m and 3m,compared with before intravitreal Ranibizumab(Lucentis) injection the mean of best corrected visual acuity(BCVA)was significant improved(t=3.015、t=3.759、t=3.938、t=3.550,P=0.004,P=0.000,P=0.000,P=0.001,P<0.05),there was significant difference with respect to the increase in the visual acuity between 1w and 3m、2m and 3m(P<0.05),there was no significant difference with respect to the increase in the visual acuity between 1w and 1m、1m and 2m(P>0.05),Before intravitreal Ranibizumab(Lucentis) injection the mean of best corrected visual acuity(BCVA)was0.159±0.213 in a single injection group,the mean best corrected visual acuity(BCVA)were 0.230±0.270、0.286±0.261、0.274±0.289、0.268±0.288 after intravitreal Ranibizumab(Lucentis)injectiont for 1w,1m,2m and 3m,compared with before intravitreal Ranibizumab(Lucentis)injection the mean of best corrected visual acuity(BCVA)was significant improved(t=1.092、t=1.841、t=2.052、t=2.259,P=0.013,P=0.002,P=0.000,P=0.001,P<0.05),the best corrected visual acuity(BCVA)of 1m 、2m and 3m was significant increased compared to that of 1w(P<0.05),there was significant difference with respect to the increase in the visual acuity between 2m and 3m(P<0.05),there was no significant difference with respect to the increase in the visual acuity between 1m and 2m(P>0.05),after intravitreal Ranibizumab(Lucentis)injectiont for 1w and 3m in continuous injection group,compared with after intravitreal Ranibizumab(Lucentis)injection for 1w and 3m in a single injection group, the mean of best corrected visual acuity(BCVA)was significant improved(P<0.05),after intravitreal Ranibizumab(Lucentis)injectiont for1 m and 2m in continuous injection group,compared with after intravitreal Ranibizumab( Lucentis)injectiont for 1m and 2m in a single injection group, the mean of best corrected visual acuity(BCVA)was no significant improved(P>0.05),There was significant difference with respect to the increase in the visual acuity in continuous injection group compared with a single injection group(P<0.05).2.After intravitreal Ranibizumab(Lucentis) injection the mean of CMT,compared with before intravitreal Ranibizumab( Lucentis) injection the mean of CMT was significant decreased,before intravitreal Ranibizumab( Lucentis) injection the mean of CMT was 373.19±136.96μm,the mean CMT were303.02±111.68 um 、 283.80±112.31 um 、 291.65±120.60 um 、 264.62±109.72 um after intravitreal Ranibizumab( Lucentis) injectiont for 1w,1m,2m and 3m,compared with before intravitreal Ranibizumab(Lucentis)injection the mean of CMT was significant decreased(t=6.099、t=6.568、t=5.454 、 t=7.353,P=0.000,P=0.000,P=0.000,P=0.000,P < 0.05),there was significant difference with respect to the decrease in the central macular thickness between 1m and 3m、2m and 3m(P<0.05),the CMT of 1m and 2m was no significant decreased to that of 1w(P>0.05),there was no significant difference with respect to the decrease in the central macular thickness between 1m and 2m(P>0.05),after treatment 3m the mean CMT was obviously decreased,Before intravitreal Ranibizumab(Lucentis)injection the mean of CMT was 458.32±130.59 um in continuous injection group,the mean CMT were280.32±111.04 um 、 263.28±116.17 um 、 260.50±126.25 um 、 237.71±115.4um after intravitreal Ranibizumab(Lucentis)injectiont for 1w,1m,2m and 3m,compared with before intravitreal Ranibizumab(Lucentis)injection the mean CMT was significant decreased(t=5.0925、t=5.428、t=4.298、t=6.341,P=0.004,P=0.000,P=0.000,P=0.000,P<0.05),there was significant difference with respect to the increase in the central macular thickness between 1w and 3m、2m and 3m(P<0.05),the CMT of 1m 、2m wasno significant decreased to that of 1w( P>0.05),there was significant difference with respect to the decrease in the central macular thickness between 1w and 3m(P<0.05),there was no significant difference with respect to the decrease in the central macular thickness between 1m and 2m 、 2m and 3m(P>0.05),after treatment 3m the mean CMT was obviously decreased;Before intravitreal Ranibizumab(Lucentis)injection the mean of CMT was 457.00±139.77 um in a single injection group,the mean CMT were 320.92±114.02 um 、 280.07±94.55 um 、 291.92±88.37 um 、 305.42±80.58 after intravitreal Ranibizumab( Lucentis) injectiont for 1w,1m,2m and 3m,compared with before intravitreal Ranibizumab(Lucentis)injection the mean of CMT was significant decreased(t=4.681、t=5.894、t=5.375、t=5.622,P=0.000,P=0.000,P=0.000,P=0.000,P<0.05),the CMT of 1m 、2m was significant decreased to that of 1w(P<0.05),there was no significant difference with respect to the decrease in the central macular thickness between 2m and 3m、1 w and 3m(P>0.05),the CMT of 2m 、3m was no significant decreased to that of 1w(P<0.05),after treatment 3m the mean CMT was obviously decreased in a single injection group;after intravitreal Ranibizumab(Lucentis) injectiont for 1w and 3m in continuous injection group,compared with after intravitreal Ranibizumab(Lucentis) injectiont for 1w and 2m in a single injection group, the mean of CMT was significant decreased(P=0.001,P=0.041,P 均<0.05).3.After intravitreal Ranibizumab(Lucentis) injection the mean of Intraocular Pressure( IOP),compared with before intravitreal Ranibizumab(Lucentis)injection the mean of Intraocular Pressure( IOP)was no significant changed,before intravitreal Ranibizumab(Lucentis) injection the mean of Intraocular Pressure(IOP)was 13.61±2.69 mm Hg,the mean Intraocular Pressure(IOP) were 3.43±2.51 mm Hg 、13.62±2.99 mm Hg、13.41±3.24 mm Hg、13.83±3.13 mm Hg after intravitreal Ranibizumab(Lucentis)injectiont for 1w,1m,2m and 3m,compared with before intravitreal Ranibizumab(Lucentis) injection the mean of Intraocular Pressure( IOP)was no significant improved(t=0.564、t=-0.038、t=0.439、t=-0.489,P=0.575,P=0.970,P=0.662,P=0.626,P>0.05),There was no significant difference between in two groups in Intraocular Pressure(IOP) before or after the treatment.There was no significant difference with respect to the increase in the Intraocular Pressure( IOP)in continuous injection group compared with a single injection group(P>0.05).4.The qualitative detection of fluid leakage by Fundus fluorescein angiography:After intravitreal Ranibizumab(Lucentis)injection the mean of fluoreseence leakage,compared with before intravitreal Ranibizumab(Lucentis) injection the mean of fluoreseence leakage was significant reduced,5.All Proliferative diabetic ratinopathy patients in intravitreal Ranibizumab( Lucentis) injection follow-up were not observed high intraocular pressure, endophthalmitis,vitreous hemorrhage,retinal detachment and other adverse reactions.Conclusion:1.Intravitreal injection of ranibizumab can improve the best corrected visual acuity of patients with proliferative diabeti cretinopathy(IV stage),There was significant difference with respect to the increase in the visual acuity in continuous injection group compared with a single injection group.2.Intravitreal injection of ranibizumab can decease the CMT in patients with Proliferative diabeticretinopathy(IV stage).3.Intravitreal injection of ranibizumab can inhibit the formation of new blood vessels,improve blood capilary leakage,can be used a periodic treatment method of Proliferative diabetic retinopathy.4.Intravitreal injection of ranibizumab treatment of proliferative diabetic retinopathy can be used a auxiliary treatment before a line laser and surgery, without obvious complications. |
PDF Full Text Request