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玻璃体内注射贝伐单抗治疗高度近视眼中黄斑中心凹下脉络膜新生血管:1年随访结果

Intravitreal bevacizumab to treat subfoveal choroidal neovascularisation in highly myopic eyes: 1-year outcome.

作者信息

Ruiz-Moreno J M, Montero J A, Gomez-Ulla F, Ares S

机构信息

Departamento de Ciencias Médicas, Facultad de Medicina, Avda de Almansa 14, 02006 Albacete, Spain.

出版信息

Br J Ophthalmol. 2009 Apr;93(4):448-51. doi: 10.1136/bjo.2008.145391. Epub 2008 Dec 17.

Abstract

AIMS

The aim of the study was to examine the changes in visual acuity, fluorescein angiography (FA) and optical coherence tomography (OCT) macular thickness of subfoveal, and juxtafoveal choroidal neovascularisation (CNV) in highly myopic eyes treated by intravitreal bevacizumab.

METHODS

The study was a prospective, non-randomised, multicentre, interventional case series. Twenty-nine highly myopic eyes from 28 patients with subfoveal and juxtafoveal CNV were treated by three monthly intravitreal injections of 1.25 mg bevacizumab. Patients were evaluated for best-corrected visual acuity (BCVA) and OCT at baseline and then monthly for 1 year. FA was performed at baseline, after 3 months, and whenever CNV activity was suspected.

RESULTS

The average age was 50 (SD 15, range 29-82) years. The mean LogMAR BCVA at baseline was 0.55 (SD 0.25, range 0.2-1.0) and 0.38 (SD 0.32, range 0.0-1.2) at 1 year. Sixteen eyes were naïve for treatment and 13 eyes had been previously treated by photodynamic therapy (average 2.5 sessions). Leakage from CNV had ceased in all eyes at month 3. OCT central foveal thickness decreased significantly from 282 (SD 68) mum at baseline to 224 (SD 46) mum at month 12 (p = 0.008, Student t test for paired data). Six eyes needed one re-injection during follow-up at month 4 (one eye), month 6 (four eyes) and month 12 (one eye). Neither ocular nor systemic adverse reactions appeared during follow-up.

CONCLUSIONS

The results of this case series suggest that intravitreal bevacizumab seems to be an effective therapeutic procedure to treat subfoveal and juxtafoveal CNV in highly myopic eyes at 1-year follow-up. Further studies are required to verify the efficacy and usefulness of this therapy compared with established treatments for this condition.

摘要

目的

本研究旨在探讨玻璃体内注射贝伐单抗治疗高度近视眼中黄斑中心凹下及黄斑旁脉络膜新生血管(CNV)后,视力、荧光素血管造影(FA)及光学相干断层扫描(OCT)测量的黄斑厚度的变化。

方法

本研究为一项前瞻性、非随机、多中心、干预性病例系列研究。对28例患有黄斑中心凹下及黄斑旁CNV的患者的29只高度近视眼睛,每3个月玻璃体内注射1.25mg贝伐单抗进行治疗。在基线时对患者进行最佳矫正视力(BCVA)和OCT评估,然后在1年内每月评估一次。在基线、3个月后以及怀疑有CNV活动时进行FA检查。

结果

平均年龄为50(标准差15,范围29 - 82)岁。基线时平均LogMAR BCVA为0.55(标准差0.25,范围0.2 - 1.0),1年后为0.38(标准差0.32,范围0.0 - 1.2)。16只眼睛为初治,13只眼睛先前接受过光动力疗法治疗(平均2.5次)。在第3个月时,所有眼睛的CNV渗漏均已停止。OCT测量的黄斑中心凹厚度从基线时的282(标准差68)μm显著降至第12个月时的224(标准差46)μm(p = 0.008,配对数据的Student t检验)。6只眼睛在随访期间的第4个月(1只眼睛)、第6个月(4只眼睛)和第12个月(1只眼睛)需要再次注射。随访期间未出现眼部或全身不良反应。

结论

该病例系列研究结果表明,在1年的随访中,玻璃体内注射贝伐单抗似乎是治疗高度近视眼中黄斑中心凹下及黄斑旁CNV的一种有效治疗方法。与针对该病症的既定治疗方法相比,需要进一步研究以验证该疗法的疗效和实用性。

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