Ronan Shawn M, Yoganathan Pradeepa, Chien Fred Y, Corcóstegui Iñigo A, Blumenkranz Mark S, Deramo Vincent A, Elner Susan G, Fastenberg David A, Johnson Mark W, López Mauricio, Mateo Carlos, Moshfeghi Darius M, Navarro Rafael, Rosenblatt Brett J, Sanislo Steven R, Saxe Stephen J, Zacks David N
Kellogg Eye Center, Department of Ophthalmology and Visual Science, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105, USA.
Retina. 2007 Jun;27(5):535-40. doi: 10.1097/IAE.0b013e3180cc2645.
Intravitreal bevacizumab (Avastin, Genentech, Inc., South San Francisco, CA) treatment of neovascular age-related macular degeneration (AMD) has become an important part of clinical retinal practice. We describe retinal pigment epithelium (RPE) tears that were noted after intravitreal injection of bevacizumab.
In this multimember, retrospective case series, data on eyes that developed RPE tears after intravitreal bevacizumab injection were collected and analyzed. Previous treatments, type of lesion, time to tear, and preinjection and final visual acuities were all compared. The total numbers of bevacizumab injections were available from all four institutions and compiled to estimate the incidence rate.
Four retina centers administered a total of 1,455 intravitreal 1.25-mg bevacizumab injections for neovascular AMD during the 9-month study period. Twelve patients presented with RPE tears within 4 days to 8 weeks of injection (mean +/- SD, 24.3 +/- 15.2 days from injection to tear). In each case, the RPE tear was preceded by an RPE detachment, and all had a component of serous sub-RPE fluid. On the basis of our collective data, we estimate an incidence rate of approximately 0.8%.
RPE tears can occur after intravitreal injection of bevacizumab. The low incidence of this adverse event should not preclude anti-vascular endothelial growth factor therapy counseling for patients with neovascular AMD, but eyes with serous RPE detachments appear to be most vulnerable to this adverse event.
玻璃体内注射贝伐单抗（阿瓦斯汀，基因泰克公司，加利福尼亚州南旧金山）治疗新生血管性年龄相关性黄斑变性（AMD）已成为临床视网膜治疗的重要组成部分。我们描述了玻璃体内注射贝伐单抗后出现的视网膜色素上皮（RPE）撕裂。
在这个多中心回顾性病例系列中，收集并分析了玻璃体内注射贝伐单抗后发生RPE撕裂的眼部数据。比较了先前的治疗方法、病变类型、撕裂时间以及注射前和最后的视力。所有四个机构都提供了贝伐单抗注射的总数，并进行汇总以估计发病率。
在为期9个月的研究期间，四个视网膜中心共为新生血管性AMD患者进行了1455次玻璃体内注射1.25毫克贝伐单抗。12例患者在注射后4天至8周内出现RPE撕裂（平均±标准差，从注射到撕裂为24.3±15.2天）。在每种情况下，RPE撕裂之前均有RPE脱离，并且所有病例均有浆液性RPE下液成分。根据我们的汇总数据，我们估计发病率约为0.8%。
玻璃体内注射贝伐单抗后可发生RPE撕裂。这种不良事件的低发生率不应妨碍对新生血管性AMD患者进行抗血管内皮生长因子治疗的咨询，但浆液性RPE脱离的眼睛似乎最易发生这种不良事件。
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