Chen Eric, Hsu Jason, Park Carl H
Retina Service, Wills Eye Institute, Philadelphia, Pennsylvania, USA.
Ophthalmic Surg Lasers Imaging. 2009 Jan-Feb;40(1):68-70. doi: 10.3928/15428877-20090101-04.
A 58-year-old woman with non-proliferative diabetic retinopathy presented with decreased visual acuity from chronic macular edema. She had undergone multiple treatments previously, including focal laser treatment and intravitreal triamcinolone acetonide. Within 2 days of treatment with intravitreal bevacizumab, the patient noted a significant decrease in visual acuity. Fluorescein angiogram demonstrated an enlargement of the foveal avascular zone and persistent late leakage following intravitreal bevacizumab; optical coherence tomography performed before and after treatment revealed persistent cystoid macular edema. The use of intravitreal bevacizumab in chronic, refractory diabetic macular edema may cause acute visual acuity loss by disrupting an already fragile vascular perfusion status, leading to macular ischemia.
一名患有非增殖性糖尿病视网膜病变的58岁女性因慢性黄斑水肿导致视力下降。她之前接受过多种治疗，包括局部激光治疗和玻璃体内注射曲安奈德。在玻璃体内注射贝伐单抗治疗的2天内，患者注意到视力显著下降。荧光素血管造影显示，玻璃体内注射贝伐单抗后，黄斑无血管区扩大且晚期持续渗漏；治疗前后进行的光学相干断层扫描显示黄斑囊样水肿持续存在。在慢性难治性糖尿病黄斑水肿中使用玻璃体内注射贝伐单抗可能会破坏本已脆弱的血管灌注状态，导致黄斑缺血，从而引起急性视力丧失。
