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维替泊芬联合玻璃体内注射贝伐单抗光动力疗法治疗年龄相关性黄斑变性脉络膜新生血管

Combined photodynamic therapy with verteporfin and intravitreal bevacizumab for choroidal neovascularization in age-related macular degeneration.

作者信息

Dhalla Mandeep S, Shah Gaurav K, Blinder Kevin J, Ryan Edwin H, Mittra Robert A, Tewari Asheesh

机构信息

Barnes Retina Institute, St Louis, MO, USA.

出版信息

Retina. 2006 Nov-Dec;26(9):988-93. doi: 10.1097/01.iae.0000247164.70376.91.

Abstract

PURPOSE

To examine the 7-month results for patients treated with combined photodynamic therapy (PDT) with verteporfin and intravitreal bevacizumab for choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).

METHODS

This is a retrospective series of 24 eyes with juxtafoveal or subfoveal CNV secondary to AMD. Patients were treated with PDT with verteporfin and 1.25 mg of intravitreal bevacizumab. All patients were naive to treatment and had either treatment within a 14-day interval. Main outcome measures were visual acuity stabilization (defined as no change or a gain in visual acuity) and retreatment rate.

RESULTS

At the 7-month follow-up, 20 (83%) of 24 patients had stabilization of visual acuity. Sixteen eyes (67%) had improvement in visual acuity. Mean improvement in visual acuity (n = 24) was 2.04 Snellen lines. Fifteen eyes (63%) required only a single combined treatment for CNV resolution. There were no complications, including endophthalmitis, uveitis, and ocular hypertension.

CONCLUSION

The results of this study suggest that combined treatment of PDT with verteporfin and intravitreal bevacizumab may be useful in treating neovascular AMD by reducing retreatment rates and improving visual acuity. Further investigation with large, controlled trials is warranted to outline the appropriate treatment paradigm for combination therapy.

摘要

目的

研究采用维替泊芬联合玻璃体腔内注射贝伐单抗光动力疗法(PDT)治疗年龄相关性黄斑变性(AMD)继发脉络膜新生血管(CNV)患者的7个月疗效。

方法

这是一项回顾性研究,纳入24例继发于AMD的黄斑中心凹旁或中心凹下CNV患者。患者接受维替泊芬PDT治疗及1.25mg玻璃体腔内注射贝伐单抗治疗。所有患者均为初治患者,且在14天内接受治疗。主要观察指标为视力稳定(定义为视力无变化或提高)和再次治疗率。

结果

在7个月随访时,24例患者中有20例(83%)视力稳定。16只眼(67%)视力提高。视力平均提高(n = 24)2.04行Snellen视力表。15只眼(63%)仅需单次联合治疗即可使CNV消退。未发生包括眼内炎、葡萄膜炎和高眼压在内的并发症。

结论

本研究结果表明,维替泊芬联合玻璃体腔内注射贝伐单抗的联合治疗可能有助于通过降低再次治疗率和提高视力来治疗新生血管性AMD。有必要通过大型对照试验进行进一步研究,以明确联合治疗的合适治疗模式。

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