Ghazi Nicola G, Knape Robert M, Kirk Tyler Q, Tiedeman James S, Conway Brian P
Department of Ophthalmology, University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Retina. 2008 May;28(5):689-95. doi: 10.1097/IAE.0b013e318162d982.
To report our short-term experience with intravitreal bevacizumab treatment of retinal angiomatous proliferation (RAP) in neovascular age-related macular degeneration (AMD).
A retrospective, interventional case series was performed that included 13 patients who received intravitreal injection of bevacizumab (1.25 mg) for treatment of RAP and completed 12 weeks of follow-up. Ophthalmic assessment included determination of best-corrected Snellen visual acuity (BCVA), complete ocular examination, fluorescein angiography, and optical coherence tomography (OCT). Injections were repeated if no further improvement or worsening was observed after an initial favorable functional and/or anatomical response. Main outcome measures were BCVA and central macular thickness (CMT) measured by OCT.
Twelve eyes (92.3%) had stable or improved BCVA, and 8 eyes (61.5%) had at least 2 lines of vision improvement. The average BCVA improved from 20/203 at baseline to 20/113 at 12 weeks (P = 0.001). Average CMT improved from 369 mum at baseline to 216 microm (P = 0.016) and 315 microm (P = 0.020) at 8 weeks and 12 weeks, respectively. Six eyes underwent fluorescein angiography at the 12-week follow-up visit; 3 (50%) of these eyes had decreased leakage compared with baseline. Both stabilization of vision and improved CMT were maintained for at least 8 weeks after a single injection in almost all eyes. No significant side effects were observed.
These short-term data suggest that bevacizumab is a viable treatment option for RAP in AMD. The initial treatment effect appears to be maintained for at least 8 weeks.
报告我们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（AMD）中视网膜血管瘤样增生（RAP）的短期经验。
进行了一项回顾性干预性病例系列研究，纳入13例接受玻璃体内注射贝伐单抗（1.25mg）治疗RAP并完成12周随访的患者。眼科评估包括测定最佳矫正视力（BCVA）、全面的眼部检查、荧光素血管造影和光学相干断层扫描（OCT）。如果在初始良好的功能和/或解剖学反应后未观察到进一步改善或病情恶化，则重复注射。主要观察指标为通过OCT测量的BCVA和中心黄斑厚度（CMT）。
12只眼（92.3%）的BCVA稳定或改善，8只眼（61.5%）至少提高了2行视力。平均BCVA从基线时的20/203提高到12周时的20/113（P = 0.001）。平均CMT分别从基线时的369μm改善到8周时的216μm（P = 0.016）和12周时的315μm（P = 0.020）。6只眼在12周随访时进行了荧光素血管造影；其中3只眼（50%）与基线相比渗漏减少。几乎所有眼睛在单次注射后视力稳定和CMT改善至少维持8周。未观察到明显副作用。
这些短期数据表明，贝伐单抗是AMD中RAP的一种可行治疗选择。初始治疗效果似乎至少维持8周。
