Tran Thi Ha Chau, Fardeau Christine, Terrada Céline, Ducos De Lahitte Ghislaine, Bodaghi Bahram, Lehoang Phuc
Department of Ophthalmology, Groupe Hospitalier Pitié Salpêtrière, Paris, France.
Graefes Arch Clin Exp Ophthalmol. 2008 Dec;246(12):1685-92. doi: 10.1007/s00417-008-0906-4. Epub 2008 Aug 6.
To assess the short-term efficacy and safety of intravitreal bevacizumab injections (IVB) for refractory choroidal neovascularization (CNV) secondary to uveitis.
Ten patients affected by choroidal neovascularization secondary to uveitis unresponsive to immunosuppression associated or not with photodynamic therapy (PDT) were consecutively included. All patients underwent a complete ophthalmic examination including best-corrected visual acuity (BCVA), fluorescein (FA) and indocyanine green angiographies (ICG), optical coherence tomography (OCT) at baseline, and after IVB injection (1.25 mg/0.05 ml).
CNV was subfoveal in eight cases and juxtafoveal in two cases. Mean follow-up was 7.5 months. After treatment, the logMAR BCVA improved from 0.62 +/- 0.4 (Snellen equivalent of 20/55) to 0.45 +/- 0.35 (Snellen equivalent of 20/40) at 1 month (p = 0.01), then remained stable during the follow-up. Mean central macular thickness (CMT) was reduced from 326 +/- 95 microm before treatment to 267 +/- 28 microm (p = 0.03) at last visit. Mean number of IVB was 2.5. Leakage from inflammatory CNV was stopped in three eyes and decreased in seven eyes. No systemic or ocular adverse events were recorded.
Intravitreal bevacizumab improves BCVA and reduces central macular thickness in eyes with inflammatory CNV refractory to immunosuppression associated or not with PDT. Further study is necessary to assess the efficacy and safety in the long term.
评估玻璃体内注射贝伐单抗(IVB)治疗葡萄膜炎继发难治性脉络膜新生血管(CNV)的短期疗效和安全性。
连续纳入10例葡萄膜炎继发脉络膜新生血管且对免疫抑制治疗(无论是否联合光动力疗法[PDT])无效的患者。所有患者在基线时以及IVB注射(1.25 mg/0.05 ml)后均接受了包括最佳矫正视力(BCVA)、荧光素血管造影(FA)和吲哚菁绿血管造影(ICG)、光学相干断层扫描(OCT)在内的全面眼科检查。
8例患者的CNV位于黄斑中心凹下,2例患者的CNV位于黄斑中心凹旁。平均随访时间为7.5个月。治疗后,1个月时logMAR BCVA从0.62±0.4(Snellen视力相当于20/55)提高到0.45±0.35(Snellen视力相当于20/40)(p = 0.01),随后在随访期间保持稳定。末次随访时,平均中心黄斑厚度(CMT)从治疗前的326±95微米降至267±28微米(p = 0.03)。IVB的平均注射次数为2.5次。3只眼炎症性CNV的渗漏停止,7只眼的渗漏减少。未记录到全身或眼部不良事件。
玻璃体内注射贝伐单抗可改善免疫抑制治疗(无论是否联合PDT)难治的炎症性CNV患者的BCVA并降低中心黄斑厚度。有必要进行进一步研究以评估其长期疗效和安全性。