Lai T Y Y, Chan W-M, Liu D T L, Luk F O J, Lam D S C
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, 3/F, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong, People's Republic of China.
Br J Ophthalmol. 2008 May;92(5):661-6. doi: 10.1136/bjo.2007.135103. Epub 2008 Mar 20.
To evaluate the efficacy of intravitreal bevacizumab (Avastin) with or without verteporfin photodynamic therapy (PDT) in the treatment of polypoidal choroidal vasculopathy (PCV).
Fifteen eyes of 15 patients with symptomatic PCV who received three monthly intravitreal bevacizumab were retrospectively reviewed. Subsequent retreatments with intravitreal bevacizumab and/or PDT were performed in patients with recurrent or persistent polypoidal lesions on indocyanine green angiography (ICGA), and persistent or recurrent subretinal fluid.
The mean follow-up duration was 12.8 months. At 3 months, the mean logMAR BCVA improved from 0.61 to 0.51 (p = 0.014), and the mean CFT reduced from 347 microm to 247 microm (p = 0.015). Despite the visual and anatomical improvements, persistent polyps were present in ICGA of all eyes at 3 months. At the last follow-up, mean BCVA remained at 0.51 after additional treatment with intravitreal bevacizumab and/or PDT (p = 0.022). Patients who had subsequent PDT were less likely to have persistent polypoidal lesions on ICGA at the last visit (p = 0.041).
Intravitreal bevacizumab appeared to result in stabilisation of vision and reduction of exudative retinal detachment in PCV patients. However, intravitreal bevacizumab monotherapy had limited effectiveness in causing regression of the polypoidal lesions in ICGA, and additional PDT appeared to be useful for treating these lesions.
评估玻璃体内注射贝伐单抗（阿瓦斯汀）联合或不联合维替泊芬光动力疗法（PDT）治疗息肉样脉络膜血管病变（PCV）的疗效。
回顾性分析15例有症状的PCV患者的15只眼，这些患者每月接受3次玻璃体内注射贝伐单抗治疗。对于吲哚菁绿血管造影（ICGA）显示有息肉样病变复发或持续存在以及视网膜下液持续或复发的患者，随后进行玻璃体内注射贝伐单抗和/或PDT再次治疗。
平均随访时间为12.8个月。3个月时，平均logMAR最佳矫正视力（BCVA）从0.61提高到0.51（p = 0.014），平均中心凹视网膜厚度（CFT）从347微米降至247微米（p = 0.015）。尽管视力和解剖结构有所改善，但3个月时所有眼的ICGA均显示有持续存在的息肉。在最后一次随访时，经玻璃体内注射贝伐单抗和/或PDT额外治疗后，平均BCVA仍保持在0.51（p = 0.022）。接受后续PDT治疗的患者在最后一次就诊时，ICGA显示息肉样病变持续存在的可能性较小（p = 0.041）。
玻璃体内注射贝伐单抗似乎可使PCV患者的视力稳定并减少渗出性视网膜脱离。然而，玻璃体内注射贝伐单抗单一疗法在使ICGA中的息肉样病变消退方面效果有限，额外的PDT似乎对治疗这些病变有用。
