Höh A E, Schaal K B, Scheuerle A, Schütt F, Dithmar S
Schwerpunkt Retinologie, Universitäts-Augenklinik, Im Neuenheimer Feld 400, 69120 Heidelberg.
Ophthalmologe. 2008 Dec;105(12):1121-6. doi: 10.1007/s00347-008-1759-2.
Macular edema (ME) due to retinal vein occlusion can be successfully treated with intravitreal bevacizumab therapy. There is no common recommendation concerning time intervals and criteria for reinjection.
Sixty-three patients (follow-up 30+/-18 weeks) received intravitreal injections of 2.5 mg bevacizumab. Reinjection was performed only if optical coherence tomography (OCT) showed persistent or recurrent ME. Check-ups were performed every 6-8 weeks.
There was complete resolution of macular edema in 31 patients after the first injection (improvement in visual acuity 3.7+/-3.7 lines); 65.2% of these patients developed recurrence of ME within 13.3+/-4.4 weeks, which completely resolved again after a second injection. Visual acuity gained the same level as after the first injection. Another relapse of ME in this group occurred in 69% of patients after another 13.4+/-5.4 weeks. Patients with persistent ME after the first injection (n=32) received a second injection, initially leading to resolution of ME in 33.3%, but all of these patients had a relapse within 13.9+/-4.1 weeks.
OCT-guided reinjection leads to anatomic and functional stabilization or improvement even if transient recurrence of ME occurs.
视网膜静脉阻塞所致黄斑水肿（ME）可通过玻璃体内注射贝伐单抗成功治疗。关于再次注射的时间间隔和标准尚无统一建议。
63例患者（随访30±18周）接受了2.5mg贝伐单抗的玻璃体内注射。仅当光学相干断层扫描（OCT）显示持续性或复发性ME时才进行再次注射。每6 - 8周进行一次检查。
31例患者首次注射后黄斑水肿完全消退（视力提高3.7±3.7行）；其中65.2%的患者在13.3±4.4周内ME复发，再次注射后完全消退。视力恢复到首次注射后的水平。该组中另外69%的患者在又过了13.4±5.4周后ME再次复发。首次注射后ME持续存在的患者（n = 32）接受了第二次注射，最初33.3%的患者ME消退，但所有这些患者在13.9±4.1周内均复发。
即使ME出现短暂复发，OCT引导下的再次注射仍可实现解剖和功能的稳定或改善。
