泛视网膜光凝与内拉尼祖马布治疗多发性糖尿病视网膜病变:一项随机临床试验
, Jeffrey G Gross1, Adam R Glassman2
1Carolina Retina Center PA, Columbia, South Carolina.
JAMA
|November 14, 2015
概括
与泛视网膜光凝固 (PRP) 治疗多发性糖尿病视网膜病变相比,拉尼祖马布注射显示视力敏度不低于两年. 这表明拉尼比祖马布是一种可行的替代治疗选择,有可能减少与PRP相关的副作用.
科学领域:
- 眼科 眼科
- 治疗糖尿病视网膜病变
- 临床试验
背景情况:
- 泛视网膜光凝 (PRP) 是增殖性糖尿病视网膜病变的标准,但可能导致视力丧失和糖尿病黄斑胀 (DME).
- 评估拉尼比祖马布作为PRP的更少侵入性的替代品对于患者的结果至关重要.
研究的目的:
- 评估静脉拉尼比祖马布在维持多发性糖尿病视网膜病变患者的视力敏度方面是否不低于PRP.
- 为了比较两种治疗方法之间的二次结果,包括视野损失和DME发展.
主要方法:
- 这是一项随机临床试验,涉及55个美国地区的305名患有多发性糖尿病视网膜病变的成年人.
- 参与者被分配给PRP或静脉内拉尼祖马布注射,在两组中,拉尼祖马布也用于DME.
- 主要结局是2年视力敏度的平均变化,次要结局评估视野,玻璃切除率,DME和新血管化.
主要成果:
- 与PRP相比,Ranibizumab显示视力敏度没有劣势 (+2. 8对 +0. 2字母的改善;P<0. 001的非劣势).
- PRP治疗导致显著增加外周视野损失,更频繁的玻璃切除术和更高的DME发育率.
- 视网膜新血管化在两组之间没有显著差异;心血管事件相似.
结论:
- 静脉内拉尼比祖马布是一种不低于PRP的治疗方法,用于治疗多发性糖尿病视网膜病变的视力.
- 拉尼比祖马布可能为PRP提供有利的替代品,可能对视野和DME产生较少的不良影响.
- 长期研究是必要的,但拉尼比祖马布对这一患者群体来说是一个有前途的治疗选择.
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