Chan Wai-Man, Lai Timothy Y Y, Liu David T L, Lam Dennis S C
Hong Kong Eye Hospital, Department of Ophthalmology & Visual Sciences, Chinese University of Hong Kong, Hong Kong, China.
Ophthalmology. 2007 Dec;114(12):2190-6. doi: 10.1016/j.ophtha.2007.03.043. Epub 2007 Jun 28.
To evaluate the safety and efficacy of intravitreal bevacizumab in the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia (PM).
Prospective, consecutive, nonrandomized, interventional case series.
Twenty-two eyes of 22 patients with CNV secondary to PM.
Consecutive patients with subfoveal or juxtafoveal CNV secondary to PM were recruited prospectively to receive an initial course of 3 monthly intravitreal injections of bevacizumab. Three additional monthly injections were performed in eyes with persistent CNV leakage after 3 months. Patients were followed up for 6 months, and the best-corrected visual acuity (BCVA), changes in fluorescein angiography, and optical coherence tomography (OCT) results were assessed.
Changes in BCVA, angiographic closure, and OCT central foveal thickness (CFT) at the 6-month follow-up.
The mean+/-standard deviation (SD) spherical equivalent refractive error of the 22 eyes was -10.3+/-3.7 D (range, -6.0D to -18.0D). All patients completed follow-up at 6 months. Twenty (90.9%) eyes had angiographic closure after 3 monthly injections of intravitreal bevacizumab, and 2 (9.1%) eyes required further treatment up to 6 months. The mean+/-SD logarithm of the minimum angle of resolution (logMAR) BCVA at baseline was 0.60+/-0.18 (Snellen equivalent, 20/80). At 1 and 6 months, the mean+/-SD logMAR BCVA improved significantly to 0.43 (Snellen equivalent, 20/53; P = 0.003) and 0.35 (Snellen equivalent, 20/45; P<0.001), respectively. The mean lines of improvements at 1 and 6 month compared with baseline were 1.7 and 2.6 lines, respectively. Fifteen (68.2%) eyes had an improvement of 2 or more lines at 6 months. The OCT results also showed significant reduction in CFT after treatment. No ocular or systemic complications were noted after intravitreal injections.
The 6-month outcomes suggest intravitreal bevacizumab to be a promising treatment method for CNV secondary to PM, resulting in both visual and anatomic improvements. Treatment resulted in complete absence of angiographic leakage in 90.9% of eyes at 3 months. Further studies to evaluate the safety, efficacy, and optimal treatment regimen are justified.
评估玻璃体内注射贝伐单抗治疗病理性近视（PM）继发脉络膜新生血管（CNV）的安全性和有效性。
前瞻性、连续、非随机、干预性病例系列研究。
22例PM继发CNV患者的22只眼。
前瞻性招募PM继发黄斑中心凹下或近黄斑中心凹CNV的连续患者，接受初始疗程，每月玻璃体内注射贝伐单抗，共3次。3个月后仍有持续性CNV渗漏的眼，再额外每月注射3次。对患者进行6个月的随访，评估最佳矫正视力（BCVA）、荧光素血管造影变化及光学相干断层扫描（OCT）结果。
6个月随访时BCVA的变化、血管造影闭合情况及OCT中心凹厚度（CFT）。
22只眼的平均±标准差（SD）等效球镜屈光不正为-10.3±3.7 D（范围为-6.0 D至-18.0 D）。所有患者均完成了6个月的随访。每月玻璃体内注射贝伐单抗3次后，20只眼（90.9%）血管造影闭合，2只眼（9.1%）在6个月内需进一步治疗。基线时最小分辨角对数（logMAR）BCVA的平均±SD为0.60±0.18（Snellen视力相当于20/80）。在1个月和6个月时，平均±SD logMAR BCVA分别显著改善至0.43（Snellen视力相当于20/53；P = 0.003）和0.35（Snellen视力相当于20/45；P<0.001）。与基线相比，1个月和6个月时平均改善行数分别为1.7行和2.6行。15只眼（68.2%）在6个月时改善2行或更多。OCT结果也显示治疗后CFT显著降低。玻璃体内注射后未观察到眼部或全身并发症。
6个月的结果表明，玻璃体内注射贝伐单抗是治疗PM继发CNV的一种有前景的治疗方法，可带来视力和解剖学上的改善。治疗3个月时，90.9%的眼血管造影完全无渗漏。有必要进一步研究评估其安全性、有效性和最佳治疗方案。
