Ranibizumab with photodynamic therapy in the treatment of wAMD / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the clinical effect of Ranibizumab combined with photodynamic therapy (PDT) for wet type age-related macular degeneration (wAMD) and the effect on the serum neovascularization factors.· METHODS:Totally 68 cases (68 eyes) of wAMD patients treated with PDT in our hospital from January 2014 to June 2016 were analyzed retrospectively.Among them,34 patients were treated by photodynamic therapy (control group) and 34 patients were treated by combination of photodynamic therapy and ranibizumab (treatment group).Comparison of BCVA,mean retinal thickness and central macular thickness (CMT) and serum neovascularization regulatory factors before and after treatment were taken between the two groups.· RESULTS:Before treatment,there was no significant difference on the BCVA,the average retinal thickness and the CMT value between the two groups (P＞0.05).At 3,6 and 12mo after treatment,the BCVA,average retinal thickness and CMT in both groups were significantly lower than those before treatment (P＜0.05).At 3,6 and 12mo after treatment,the BCVA,the average retinal thickness and the CMT value of the patients in the treatment group were significantly lower than those in the control group (P＜0.05).There was no significant difference of vascular endothelial growth factor (VEGF),platelet derived growth factor (PDGF),matrix metallo-proteinase inhibitor (TIMP)-1 and endostatin (ES) between the two groups before treatment (P＞ 0.05).Three months after treatment,VEGF,PDGF and ES in both groups were significantly lower than those before treatment (P＜0.05).Three months after treatment,the levels of VEGF,PDGF and ES in the treatment group were significantly lower than those in the control group (P＜0.05).· CONCLUSION:The wAMD patients treated with ranibizumab combined with photodynamic therapy can achieve a more significant clinical effect,and more effectively reduce the level of serum neovascularization regulators.

Spontaneous Suprachoroidal Hemorrhage Associated with Wet Type of Age-Related Macular Degeneration and Hypertension: Two Cases

PURPOSE: To report two cases of spontaneous suprachoroidal hemorrhage associated with wet type of age-related macular degeneration (ARMD) and systemic hypertension. CASE SUMMARY: Two women, aged 76 and 73 years, with a history of systemic hypertension for more than ten years had been treated in an eye clinic for wet type of ARMD. The 76-year-old woman was scheduled to receive an injection of intravitreal Lucentis(R) but experienced sudden onset loss of vision and ocular pain in her left eye. The 73-year-old woman had received no specific treatment for wet type of ARMD. She also complained of visual disturbance and ocular pain. In these two cases, slit lamp or B-scan examination disclosed suprachoroidal hemorrhage. Surgical intervention relieved the ocular pain and symptoms in both cases. CONCLUSIONS: Even if a patient has not received systemic anticoagulation/thrombolytic therapy, if wet-type ARMD patients are elderly and have systemic hypertension, they should receive regular follow-ups because old age and systemic hypertension are risk factors of spontaneous suprachoroidal hemorrhage.