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.
Anti-vascular dndothelial growth factor (VEGF) drugs have open up a new treatment channel for ocular neovascular diseases. A lots of clinical data has proved that anti-VEGF drugs are effective and safe. But we should also notice that long-term and excessive usage of anti-VEGF drugs brings some new problems and complications, and even affect the normal ocular physiological process of the angiogenesis and retinal blood flow. So, it is necessary to pay attention to the problems and potential risks of excessive usage of anti-VEGF therapies for ocular neovascular disease.
Up-regulation of vascular endothelial growth factor (VEGF) is demonstrated to be a key role in formation process of intraocular neovascularization. Anti-VEGF treatment is the breakthrough of intraocular neovascular diseases therapy. Intrav itreal injection of antineovascularization drug looks to be an effective method on ocular neovascular diseases which with the advantages of good biocompatibility, low prices and longer intravitreal half-time etc. However, at present, it lack of multi-center study; the long-term efficacy and the systematic safety needs the further clinical verification. Various types of CNV showed the different therapeutic reactions to either PDT or Anti-VEGF agent, the treatment methods for exudative AMD include laser, PDT, and drug like Triamcinolone Acetonide，several anti-VEGF preparations. Therefore, understanding the pathogenesis of neovascular AMD and choosing a reasonable therapeutic methods are necessary. We should try to explore a safe, effective, economic, new approach. （Chin J Ocul Fundus Dis，2008，24：157-159）
Objective To observe the inhibitory effect of Bevacizumab on retinal neovascularization in oxygen-induced retinopathy in the mouse. Methods 90 one-week-old C57B L/6J mice were divided into four groups at random. 15 mice in the 1st group as normal control group, 15 mice in the 2nd group as oxygen control group, 30 mice in the 3rd group as high-dose Bevacizumab treatment group, 30 mice in the 4th group as low-dose Bevacizumab treatment group. The 2nd, 3rd and 4th groups were exposed to 75% oxygen for 5 days and then to room air. At the 12th day, One eye of each mouse of two control groups were received an intravitreal injection with Be vacizumab at 2 mu;l、1 mu;l respectively, and the same volume of BSS was injected into the other eye of the mice. The adenosine diphosphatase (ADPase) histochemical technique was used for retinal flat mount to assess the oxygen-induced change s of retinal vessels. The number of the endothelium cell nuclei of proliferative neovascularization was quantified by retinal microtome chromoscopy. Real-time PCR analysis was performed to examine the expression of VEGF mRNA. Results Comparing with oxygen control group, regular distributions, reduced density of retina l vascular and reduced endothelium cell nuclei which extending retinal membrane were observed in the treatment groups(P＜0.001). But the differences between two treatment groups are not statistically significant (P＞0.05). The expression of VEGF mRNA was not significantly different in oxygen control group whatever it whether accepted Bevacizumab treatment or high or low dose (P＞0.05). Conclusion Intravitreal injection with Bevacizumab can effectively inhibits the retinal neova scularization in oxygen-induced retinopathy in the mouse. Intravitreal injection with Bevacizumab might become to the new method to treat retinopathy of premature. （Chin J Ocul Fundus Dis，2008，24：184-188）
Objective To observe the efficacy of intravitreal injection of ranibizumab (IVR) for different patterns of optical coherence tomography (OCT) of diabetic macular edema and the relationship between integrity of ellipsoidal zone and visual acuity outcomes. Methods Eighty-five IVR treated eyes were enrolled. The examination of BCVA was according to Early Treatment Diabetic Retinopathy Study, and the results were recorded as logarithm of the minimum angle of resolution (logMAR). Frequency-domain OCT was used to measure the central foveal thickness (CFT) and the integrity of ellipsoidal zone. All eyes were classified as diffuse macular edema (DRT group, 31 eyes), cystoid macular edema (CME group, 29 eyes), and serous retinal detachment (SRD group, 25 eyes). All the patients were treated with intravitreal injection of 0.05 ml (0.5 mg) ranibizumab. The mean follow-up time was (9.21+3.56) months after IVR treatment. The changes of BCVA and CFT in 3 groups were compared and analyzed after 3, 6 and 12 months. According to visual acuity at different ranges, the relationship between integrity of ellipsoidal zone and BCVA was analyzed. Results Compared with the average logMAR BCVA before treatment, except for 12 months after treatment in group SRD (t=2.104,P=0.053), the average logMAR BCVA after IVR at 3 months, 6 months and 12 months improved in DRT group (t=7.847, 6.771, 6.426;P=0.000, 0.000, 0.000), CME group (t=8.560, 6.680, 5.082;P=0.000, 0.000, 0.000) and SRD group (t=5.161, 3.968, 2.104;P=0.000, 0.001, 0.053). The average logMAR BCVA of the DRT group was lesser than that in CME and SRD group after 12 months treatment (t=–2.043, –3.434;P=0.030, 0.001). The average CFT after IVR at 3 months, 6 months and 12 months reduced significantly in DRT group (t=12.746, 10.687, 9.425;P=0.000, 0.000, 0.000), CME group (t=13.400, 11.460, 10.169;P=0.000, 0.000, 0.000), and SRD group (t=11.755, 10.100, 9.173;P=0.000, 0.000, 0.000). After 12 months of treatment, the average CFT of the SRD group was thicker than that in DRT group and CME group (t=–3.251, –1.227;P=0.003, 0.025); there was significant difference in the integrity of ellipsoidal zone among 3 groups (χ2=1.267,P=0.531). The results showed that there were significant differences in the integrity of ellipsoidal zone with different ranges of BCVA before and after 12 months treatment (χ2=20.145, 41.035;P=0.000, 0.000). Conclusions IVR could significantly improve the visual acuity of different patterns of DME, reduced the CFT, and had the best efficacy in the DRT group. There was relationship between the integrity of ellipsoidal zone and the visual acuity outcomes.