Chan Wai-Man, Lai Timothy Y Y, Liu David T L, Lam Dennis S C
Hong Kong Eye Hospital, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
Am J Ophthalmol. 2007 Jun;143(6):977-983. doi: 10.1016/j.ajo.2007.02.039. Epub 2007 Apr 24.
PURPOSE: To evaluate the safety and efficacy of intravitreal bevacizumab in the treatment of idiopathic choroidal neovascularization (CNV) and CNV secondary to central serous chorioretinopathy (CSC) or punctate inner choroidopathy (PIC). DESIGN: Prospective, nonrandomized, interventional case series. METHODS: In an institutional clinical practice, 15 patients were recruited; nine had idiopathic CNV, two had CNV secondary to CSC, and four had CNV attributable to PIC. Patients received three monthly 1.25-mg intravitreal bevacizumab injections for three months. Patients were followed for six months, and the best-corrected visual acuity (BCVA), fluorescein angiography (FA) findings, and optical coherence tomography (OCT) central foveal thickness (CFT) were assessed. RESULTS: At baseline, the mean logMAR BCVA was 0.48 (Snellen equivalent = 20/60). The mean logMAR BCVA improved significantly to 0.25 (Snellen equivalent = 20/36) and 0.17 (Snellen equivalent = 20/30) at one and six months, respectively (both P = .001). The mean OCT CFT reduced from 306 microm at baseline to 201 microm at six months (P < .001). All eyes (100%) had visual improvement of 1 line or more at six months, and 11 (73.3%) improved by 2 or more lines. FA showed absence of CNV leakage, the angiographic end point, at three months, and no recurrence was observed at six months in all eyes. No systemic or ocular adverse events were encountered. CONCLUSIONS: Intravitreal bevacizumab injections resulted in visual and anatomic improvements in eyes with idiopathic CNV and CNV attributable to CSC or PIC. Further studies are warranted to assess the long-term safety and the regimen for optimal efficacy of intravitreal bevacizumab.
目的:评估玻璃体内注射贝伐单抗治疗特发性脉络膜新生血管(CNV)以及继发于中心性浆液性脉络膜视网膜病变(CSC)或点状内层脉络膜病变(PIC)的CNV的安全性和有效性。 设计:前瞻性、非随机、干预性病例系列研究。 方法:在机构临床实践中招募了15例患者;其中9例患有特发性CNV,2例患有继发于CSC的CNV,4例患有由PIC引起的CNV。患者接受为期三个月的每月一次1.25mg玻璃体内贝伐单抗注射,共注射三次。对患者进行为期六个月的随访,并评估最佳矫正视力(BCVA)、荧光素血管造影(FA)结果以及光学相干断层扫描(OCT)测量的中心凹厚度(CFT)。 结果:基线时,平均logMAR BCVA为0.48(Snellen视力相当于20/60)。在1个月和6个月时,平均logMAR BCVA分别显著改善至0.25(Snellen视力相当于20/36)和0.17(Snellen视力相当于20/30)(P均=0.001)。平均OCT CFT从基线时的306微米降至6个月时的201微米(P<0.001)。所有患眼(100%)在6个月时视力提高了1行或更多,11只眼(73.3%)提高了2行或更多。FA显示在3个月时无CNV渗漏(血管造影终点),所有患眼在6个月时均未观察到复发。未遇到全身或眼部不良事件。 结论:玻璃体内注射贝伐单抗可使患有特发性CNV以及继发于CSC或PIC的CNV的患眼在视力和解剖结构上得到改善。有必要进行进一步研究以评估玻璃体内注射贝伐单抗的长期安全性和最佳疗效方案。
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