Chen Eric, Kaiser Richard S, Vander James F
Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Retina. 2007 Apr-May;27(4):445-50. doi: 10.1097/01.iae.0000249574.89437.40.
New medications targeting vascular endothelial growth factor show promise in the treatment of wet macular degeneration. This study describes the clinical response and optical coherence tomography (OCT) findings for patients with refractory pigment epithelial detachment (PED) and occult choroidal neovascular membranes (CNVMs) who were treated with intravitreal bevacizumab.
A retrospective analysis of data for 10 patients with fibrovascular PEDs, initially treated with intravitreal pegaptanib, thermal laser, or photodynamic therapy with or without triamcinolone acetonide administration, was performed. All patients were refractory to previous treatment. They received monthly injections of bevacizumab and were followed by clinical examination, angiography, and OCT.
Nine of 10 patients had stable or improved vision. Angiogram findings showed resolution of leakage from CNVMs. OCT demonstrated resolution of the subretinal or intraretinal fluid but persistence of the PED itself. Vision improvement was correlated with OCT changes.
Intravitreal bevacizumab may be a viable option in treating patients with fibrovascular PEDs. OCT findings suggest that visual improvement is secondary to resolution of subretinal and intraretinal edema without resolution of the PED.
针对血管内皮生长因子的新型药物在湿性黄斑变性治疗中显示出前景。本研究描述了接受玻璃体内注射贝伐单抗治疗的难治性色素上皮脱离（PED）和隐匿性脉络膜新生血管膜（CNVM）患者的临床反应和光学相干断层扫描（OCT）结果。
对10例纤维血管性PED患者的数据进行回顾性分析，这些患者最初接受玻璃体内注射培加尼布、热激光或光动力疗法治疗，部分患者联合或不联合曲安奈德给药。所有患者对先前治疗均无效。他们每月接受贝伐单抗注射，并接受临床检查、血管造影和OCT检查。
10例患者中有9例视力稳定或改善。血管造影结果显示CNVM渗漏消失。OCT显示视网膜下或视网膜内液消失，但PED本身持续存在。视力改善与OCT变化相关。
玻璃体内注射贝伐单抗可能是治疗纤维血管性PED患者的可行选择。OCT结果表明，视力改善是视网膜下和视网膜内水肿消退的结果，而PED并未消退。
