Jaissle G B, Ziemssen F, Petermeier K, Szurman P, Ladewig M, Gelisken F, Völker M, Holz F G, Bartz-Schmidt K U
Abt. I, Universitätsaugenklinik Tübingen, Schleichstrasse 12, 72076 Tübingen.
Ophthalmologe. 2006 Jun;103(6):471-5. doi: 10.1007/s00347-006-1355-2.
Application of VEGF inhibitors represents a treatment option for macular edema secondary to retinal vein occlusion that targets the disease at the causal molecular level. First reports on intravitreal injections of bevacizumab show promising morphological and functional effects and demonstrate that bevacizumab is a potent antiedematous agent in this context. A significant reduction of the central retinal thickness followed by a rapid improvement of visual acuity may be achieved within days. In a pilot study with a review period of 3 months, we found a significant improvement of one or more lines in 93% and four or more lines in 27% of eyes. This was associated with a concomitant significant reduction in central retinal thickness, which, however, was not sustained by a single injection (64% reduction after 1 month and 28% after 3 months). No relevant adverse events were noted. The duration of action after intravitreal bevacizumab administration is currently unknown. Reinjections will be necessary to maintain a lasting beneficial effect. Prospective, controlled long-term studies are mandatory to develop standardized treatment protocols that allow a safe and effective application of this off-label therapy.
血管内皮生长因子(VEGF)抑制剂的应用是针对视网膜静脉阻塞继发黄斑水肿的一种治疗选择,它在致病分子水平上针对该疾病。首次关于玻璃体内注射贝伐单抗的报告显示出有希望的形态学和功能效果,并表明在这种情况下贝伐单抗是一种有效的抗水肿药物。在数天内可实现中心视网膜厚度显著降低,随后视力迅速改善。在一项为期3个月的回顾期的初步研究中,我们发现93%的眼睛视力提高了一行或多行,27%的眼睛视力提高了四行或多行。这与中心视网膜厚度同时显著降低相关,然而,单次注射并不能维持这种降低(1个月后降低64%,3个月后降低28%)。未观察到相关不良事件。目前尚不清楚玻璃体内注射贝伐单抗后的作用持续时间。需要再次注射以维持持久的有益效果。必须进行前瞻性、对照的长期研究,以制定标准化治疗方案,从而安全有效地应用这种非标签治疗方法。