Center for Ophthalmology, University of Tuebingen, Tuebingen, BW, Germany.
Eye (Lond). 2009 Mar;23(3):694-702. doi: 10.1038/sj.eye.6703098. Epub 2008 Feb 1.
To analyse retinal pigment epithelial (RPE) tears following single administration of intravitreal bevacizumab for neovascular age-related macular degeneration (AMD) during early follow-up.
Interventional, retrospective, non-comparative case series included 397 patients (409 eyes) of the 746 consecutive patients that met the eligibility criteria. Standardized visual acuity testing, fluorescein angiography, and optical coherence tomography were performed. Data collected included status of the fellow eye, previous treatment, subtypes of choroidal neovascularization (CNV), size and composition of the lesion. Multiple linear regression modelling was used to explore the effect of baseline parameters on the RPE tears. Primary end point was occurrence of RPE tears within 6 weeks after therapy.
Fifteen of the 409 eyes (3.6%) developed RPE tear (95% confidence interval: 2.2-6.0, odds ratio: 26.3). The statistical modelling showed significant association between RPE tear and occult without classic CNV/predominantly haemorrhage vspredominantly/minimal classic CNV (P=0.019), as well as medium or large (>4 disc area) vssmall size of the total lesion (P=0.038). Previous treatment and status of the fellow eye did not statistically influence the risk of RPE tears.
An RPE tear can develop in up to 3.6% of eyes with neovascular AMD following single administration of intravitreal bevacizumab in a short-term follow-up. Medium and large lesion size and occult without classic and predominantly haemorrhagic subtype of CNV were important predictive factors. Preoperative assessment of the lesion characteristics may help in identifying the risk of individual patients with neovascular AMD before intravitreal bevacizumab treatment.
分析在接受单次玻璃体内贝伐单抗治疗新生血管性年龄相关性黄斑变性（AMD）后的早期随访中视网膜色素上皮（RPE）撕裂的情况。
本研究为介入性、回顾性、非对照病例系列研究，共纳入 746 例符合入选标准的连续患者中的 397 例（409 只眼）。进行标准化视力测试、荧光素血管造影和光学相干断层扫描。收集的数据包括对侧眼的状态、既往治疗、脉络膜新生血管（CNV）的亚型、病变的大小和组成。采用多元线性回归模型来探讨基线参数对 RPE 撕裂的影响。主要终点是治疗后 6 周内发生 RPE 撕裂。
409 只眼中有 15 只（3.6%）发生 RPE 撕裂（95%置信区间：2.2-6.0，优势比：26.3）。统计建模显示，RPE 撕裂与隐匿性而非经典型 CNV/主要为出血型与主要为最小经典型 CNV 之间存在显著相关性（P=0.019），以及中或大（>4 个视盘面积）与小病变总大小（P=0.038）之间存在显著相关性。既往治疗和对侧眼的状态对 RPE 撕裂的风险没有统计学影响。
在短期随访中，接受单次玻璃体内贝伐单抗治疗的新生血管性 AMD 患者中，多达 3.6%的患者可能会发生 RPE 撕裂。病变的大小、隐匿性而非经典型和主要为出血型 CNV 亚型是重要的预测因素。在接受玻璃体内贝伐单抗治疗之前，对病变特征进行术前评估可能有助于识别接受新生血管性 AMD 治疗的个体患者的风险。
