Cordero Coma Miguel, Sobrin Lucia, Onal Sumru, Christen William, Foster C Stephen
Massachusetts Eye Research and Surgery Institute, Cambridge, Massachusetts 02142, USA.
Ophthalmology. 2007 Aug;114(8):1574-1579.e1. doi: 10.1016/j.ophtha.2006.11.028. Epub 2007 Mar 23.
To evaluate the short-term safety and efficacy of intravitreal bevacizumab for the treatment of cystoid macular edema (CME) secondary to uveitis.
Retrospective, noncomparative, interventional case series.
Thirteen patients undergoing treatment for recalcitrant uveitic macular edema at one referral center.
Charts of patients who received one 2.5-mg intravitreal injection of bevacizumab in one eye were reviewed for clinical information including best-corrected Snellen visual acuity (VA), examination findings, optical coherence tomography (OCT) results, and fluorescein angiography results. Kaplan-Meier survival analysis was used to calculate probability success rates. The statistical significance of change in mean retinal thickness and VA was assessed using repeated-measures analysis of variance.
Assessments of changes in best-corrected Snellen VA and OCT retinal thickness were made.
Six (46.15%) patients had a decrease in foveal thickness at the end of the follow-up, whereas 5 (38.4%) patients had an improvement of VA by > or =2 lines 84 days or more after the injection. Mean retinal thickness showed a significant decrease over the follow-up (P<0.02). The change in mean logarithm of the minimum angle of resolution VA over the follow-up was not significant (P>0.05). Survival analysis showed that the probability of any improvement in VA increased progressively starting at 6 weeks and reached 81% at 14 weeks. No significant ocular or systemic adverse effects were observed.
These results suggest that a single intravitreal injection of bevacizumab is well tolerated and is associated with short-term improvement in VA and decreased OCT retinal thickness in a considerable proportion of patients with uveitic CME resistant to conventional therapy. Further evaluation of intravitreal bevacizumab for uveitic CME in controlled randomized studies is warranted.
评估玻璃体内注射贝伐单抗治疗葡萄膜炎继发黄斑囊样水肿(CME)的短期安全性和有效性。
回顾性、非对照、干预性病例系列研究。
在一个转诊中心接受顽固性葡萄膜炎性黄斑水肿治疗的13例患者。
回顾接受单眼2.5mg玻璃体内注射贝伐单抗患者的病历,收集临床信息,包括最佳矫正视力(VA)、检查结果、光学相干断层扫描(OCT)结果和荧光素血管造影结果。采用Kaplan-Meier生存分析计算成功率。使用重复测量方差分析评估平均视网膜厚度和视力变化的统计学意义。
评估最佳矫正视力和OCT视网膜厚度的变化。
随访结束时,6例(46.15%)患者黄斑中心凹厚度降低,5例(38.4%)患者在注射后84天或更长时间视力提高≥2行。随访期间平均视网膜厚度显著降低(P<0.02)。随访期间最小分辨角对数视力的平均变化无统计学意义(P>0.05)。生存分析显示,视力任何改善的概率从6周开始逐渐增加,在14周时达到81%1%。未观察到明显的眼部或全身不良反应。
这些结果表明,单次玻璃体内注射贝伐单抗耐受性良好,在相当一部分对传统治疗耐药的葡萄膜炎性CME患者中与短期视力改善和OCT视网膜厚度降低相关。有必要在对照随机研究中进一步评估玻璃体内注射贝伐单抗治疗葡萄膜炎性CME的效果。