Meyerle Catherine B, Freund K Bailey, Iturralde Diana, Spaide Richard F, Sorenson John A, Slakter Jason S, Klancnik James M, Fisher Yale L, Cooney Michael J, Yannuzzi Lawrence A
LuEsther T. Mertz Retinal Research Center/Manhattan Eye, Ear & Throat Hospital and Vitreous-Retina-Macula Consultants of New York, New York, USA.
Retina. 2007 Apr-May;27(4):451-7. doi: 10.1097/IAE.0b013e318030ea80.
To evaluate the short-term visual acuity and anatomic responses after intravitreal bevacizumab (Avastin, Genentech) treatment in patients with retinal angiomatous proliferation (RAP).
The authors conducted a retrospective review of consecutive patients with newly diagnosed or recurrent RAP treated with intravitreal bevacizumab (1.25 mg) during a 3-month period. Complete ocular examination was performed at baseline and follow-up visits. Interval data were analyzed statistically at 1 and 3 months follow-up.
Twenty-three eyes of 23 patients underwent intravitreal bevacizumab treatment. The mean age of patients was 81.1 years, median baseline visual acuity of treated eyes was 20/80 (range 20/25-20/800), and mean baseline central macular thickness was 335 mum (optical coherence tomography was available for 22 eyes). Nine eyes had retinal pigment epithelial detachments (PEDs) at baseline. At 1-month follow-up, the median acuity improved to 20/60 (range 20/30-20/400) (P < 0.001), mean central macular thickness decreased to 202 microm (P < 0.001), and PED was present in only 2 eyes (P = 0.016). Seven of 23 eyes at 1 month (30.4%) had improved visual acuity, defined as halving of the visual angle, and no eyes had worse acuity, defined as doubling of the visual angle. Of the 17 eyes available for 3-month follow-up, 5 eyes (29.4%) had better visual acuity, 1 eye (5.9%) had worse acuity, and the remaining 11 (64.7%) had the same acuity. The median visual acuity at month 3 was 20/60 (range 20/25-20/400). There were no thromboembolic phenomena, endophthalmitis cases, retinal detachments, or any other adverse events.
Treatment of RAP with intravitreal bevacizumab during this retrospective review resulted in a significant decrease in macular thickness and improvement or stabilization of visual acuity. Further long-term investigation is warranted given the promising short-term results.
评估玻璃体内注射贝伐单抗（阿瓦斯汀，基因泰克公司生产）治疗视网膜血管瘤样增生（RAP）患者后的短期视力和解剖学反应。
作者对在3个月期间接受玻璃体内注射贝伐单抗（1.25毫克）治疗的新诊断或复发性RAP连续患者进行了回顾性研究。在基线和随访时进行了完整的眼部检查。在随访1个月和3个月时对间隔数据进行了统计学分析。
23例患者的23只眼接受了玻璃体内注射贝伐单抗治疗。患者的平均年龄为81.1岁，治疗眼的基线视力中位数为20/80（范围20/25 - 20/800），基线中心黄斑厚度平均为335微米（22只眼可进行光学相干断层扫描）。9只眼在基线时有视网膜色素上皮脱离（PED）。在1个月随访时，视力中位数提高到20/60（范围20/30 - 20/400）（P < 0.001），中心黄斑厚度平均降至202微米（P < 0.001），仅2只眼存在PED（P = 0.016）。23只眼中有7只眼（30.4%）在1个月时视力得到改善，定义为视角减半，没有眼视力变差，定义为视角加倍。在可进行3个月随访的17只眼中，5只眼（29.4%）视力更好，1只眼（5.9%）视力变差，其余11只眼（64.7%）视力相同。3个月时的视力中位数为20/60（范围20/25 - 20/400）。没有血栓栓塞现象、眼内炎病例、视网膜脱离或任何其他不良事件。
在本次回顾性研究中，玻璃体内注射贝伐单抗治疗RAP导致黄斑厚度显著降低，视力得到改善或稳定。鉴于短期结果令人鼓舞，有必要进行进一步的长期研究。
