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玻璃体内注射贝伐单抗治疗新生血管性年龄相关性黄斑变性:连续三个月每月注射的疗效

Treatment of neovascular age-related macular degeneration with intravitreal bevacizumab: efficacy of three consecutive monthly injections.

作者信息

Melamud Alex, Stinnett Sandra, Fekrat Sharon

机构信息

Duke University Eye Center, Erwin Road, Durham, NC 27710, USA.

出版信息

Am J Ophthalmol. 2008 Jul;146(1):91-5. doi: 10.1016/j.ajo.2008.03.014. Epub 2008 May 2.

Abstract

PURPOSE

To report the efficacy of treatment of neovascular age-related macular degeneration (AMD) with intravitreal bevacizumab (Avastin; Genentech, Inc, South San Francisco, California, USA) when administered in a series of three monthly injections followed by a period of observation.

DESIGN

Retrospective case series.

METHODS

Retrospective review of consecutive eyes with all choroidal neovascular lesion subtypes resulting from neovascular AMD treated with intravitreal bevacizumab. Treatment consisted of a pars plana injection of 1.25 mg Avastin (0.05 ml bevacizumab at a concentration of 25 mg/ml). Evaluation consisted of a complete ophthalmologic examination, including best-corrected visual acuity (VA) measurement, ophthalmoscopy, and optical coherence tomography. Eyes received a series of three monthly injections followed by a three-month period of observation.

RESULTS

A total of 36 patients (37 eyes) received a series of three consecutive monthly intravitreal injections of bevacizumab. Twenty (54%) of 37 eyes had no previous treatments for neovascular AMD in the eye that received bevacizumab. Seventeen (46%) of 37 eyes had received some previous treatment before initiation of bevacizumab therapy. Intravitreal Avastin therapy produced an improvement in foveal thickness over time in eyes with neovascular AMD. This improvement was sustained during the series of three monthly injections. All eyes experienced worsening after three months without treatment. No statistically significant effect on VA was demonstrated in this series.

CONCLUSION

Intravitreal bevacizumab therapy produced an improvement in foveal thickness over time in eyes with neovascular AMD when one injection was given each month for three consecutive months. All eyes experienced increased foveal thickening during the subsequent three months without treatment.

摘要

目的

报告玻璃体内注射贝伐单抗(阿瓦斯汀;基因泰克公司,美国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)的疗效,治疗方案为每月注射一次,共三次,随后进行观察期。

设计

回顾性病例系列。

方法

回顾性分析连续纳入的因新生血管性AMD导致的所有脉络膜新生血管病变亚型的患眼,这些患眼接受了玻璃体内贝伐单抗治疗。治疗方法为经睫状体扁平部注射1.25mg阿瓦斯汀(0.05ml浓度为25mg/ml的贝伐单抗)。评估包括全面的眼科检查,包括最佳矫正视力(VA)测量、检眼镜检查和光学相干断层扫描。患眼接受每月一次的三次注射,随后进行三个月的观察期。

结果

共有36例患者(37只眼)连续三个月每月接受一次玻璃体内贝伐单抗注射。37只眼中有20只(54%)在接受贝伐单抗治疗的患眼之前未接受过新生血管性AMD的治疗。37只眼中有17只(46%)在开始贝伐单抗治疗前接受过一些先前的治疗。玻璃体内阿瓦斯汀治疗使新生血管性AMD患眼的黄斑中心凹厚度随时间改善。这种改善在连续三个月每月注射期间得以维持。所有患眼在三个月未治疗后病情恶化。本系列研究未显示对VA有统计学显著影响。

结论

对于新生血管性AMD患眼,连续三个月每月注射一次玻璃体内贝伐单抗治疗可使黄斑中心凹厚度随时间改善。所有患眼在随后三个月未治疗期间黄斑中心凹厚度均增加。

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