Mandal Subrata, Garg Satpal, Venkatesh Pradeep, Mithal Charu, Vohra Rajpal, Mehrotra Abhas
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
Arch Ophthalmol. 2007 Nov;125(11):1487-92. doi: 10.1001/archopht.125.11.1487.
To evaluate the short-term visual and anatomical outcomes and safety of intravitreal bevacizumab in subfoveal idiopathic choroidal neovascularization.
Thirty-two eyes of 32 patients with idiopathic choroidal neovascularization received intravitreal bevacizumab (1.25 mg/0.05 mL) in this prospective, noncomparative, interventional case series. Injection was repeated if optical coherence tomography showed intraretinal edema, subretinal fluid, and/or pigment epithelial detachment at a 4-week interval. Ophthalmic evaluations included best-corrected visual acuity, optical coherence tomography, and fundus fluorescein angiography. Patients were followed up for at least 12 weeks.
The mean follow-up period was 4.2 months. At 12 weeks, the mean best-corrected visual acuity improved from 20/133 (median, 20/200) to 20/50 (median, 20/40) (P < .001). The mean central macular thickness was reduced from 314.37 microm to 236.84 microm (P < .001). At the final visit, 19 eyes (59%) had an improvement of best-corrected visual acuity of 3 or more lines, 11 eyes (34%) remained stable, and 2 eyes (6%) lost 3 or more lines. No significant ocular or systemic adverse effects were observed.
Short-term results suggest that intravitreal bevacizumab is safe and well tolerated in idiopathic choroidal neovascularization. Many patients showed marked improvement in visual acuity and a decrease in central macular thickness. Further evaluation with longer follow-up is needed to confirm long-term efficacy and safety.
评估玻璃体内注射贝伐单抗治疗中心凹下特发性脉络膜新生血管的短期视力、解剖学转归及安全性。
在这个前瞻性、非对照、干预性病例系列研究中,32例特发性脉络膜新生血管患者的32只眼接受了玻璃体内注射贝伐单抗(1.25 mg/0.05 mL)。如果光学相干断层扫描显示视网膜内水肿、视网膜下液和/或色素上皮脱离,则每隔4周重复注射。眼科评估包括最佳矫正视力、光学相干断层扫描和眼底荧光血管造影。患者随访至少12周。
平均随访期为4.2个月。在12周时,平均最佳矫正视力从20/133(中位数,20/200)提高到20/50(中位数,20/40)(P <.001)。平均黄斑中心厚度从314.37微米降至236.84微米(P <.001)。在最后一次随访时,19只眼(59%)的最佳矫正视力提高了3行或更多,11只眼(34%)保持稳定,2只眼(6%)下降了3行或更多。未观察到明显的眼部或全身不良反应。
短期结果表明,玻璃体内注射贝伐单抗治疗特发性脉络膜新生血管安全且耐受性良好。许多患者的视力有显著改善,黄斑中心厚度减小。需要进一步进行更长时间的随访评估以确认长期疗效和安全性。