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玻璃体内注射贝伐单抗治疗糖尿病性黄斑水肿。

Intravitreal bevacizumab for treatment of diabetic macular edema.

作者信息

Seo Jeong Won, Park In Won

机构信息

Department of Ophthalmology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.

出版信息

Korean J Ophthalmol. 2009 Mar;23(1):17-22. doi: 10.3341/kjo.2009.23.1.17. Epub 2009 Mar 9.

DOI:10.3341/kjo.2009.23.1.17
PMID:19337474
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2655742/
Abstract

PURPOSE

To evaluate the effect of intravitreal bevacizumab on visual function and retinal thickness in patients with diabetic macular edema (DME).

METHODS

Thirty eyes of twenty-eight patients (mean age, 57.9+/-13.8 years) with DME were included in this study. Complete ophthalmic examination, including determination of best-corrected visual acuity (BCVA), stereoscopic biomicroscopy, and retinal thickness measurement by optical coherence tomography (OCT), was done at baseline and at each follow-up visit. All patients were treated with a 0.05 mL intravitreal injection containing 1.25 mg of bevacizumab.

RESULTS

All patients completed 3 months of follow-up with a mean follow-up period of 5.26+/-2.39 months. The mean BCVA at baseline was 0.73+/-0.36 logMAR, which significantly improved to 0.63+/-0.41 (p=0.02), 0.58+/-0.36 (p=0.003), and 0.61+/-0.40 logMAR (p=0.006) at 1 week, 1 month, and 3 months. Final BCVA analysis demonstrated that 15 eyes (50%) remained stable and 12 (40%) improved >or=2 lines on BCVA. The mean central retinal thickness was 498.96+/-123.99 microm at baseline and decreased to 359.06+/-105.97 (p<0.001), 334.40+/-121.76 (p<0.001), 421.40+/-192.76 microm (p=0.035) at 1 week, 1 month, and 3 months. No ocular toxicity or adverse effects were observed.

CONCLUSIONS

Intravitreal bevacizumab injection resulted in significant improvement in BCVA and central retinal thickness as early as 1 week after injection in patients with DME, and this beneficial effect persisted for up to 3 months. However, the slight reduction in this improvement at 3 months suggests that repeated bevacizumab injections might be necessary. To evaluate the long-term safety and efficacy, further prospective randomized controlled clinical trials will be needed.

摘要

目的

评估玻璃体内注射贝伐单抗对糖尿病性黄斑水肿(DME)患者视觉功能和视网膜厚度的影响。

方法

本研究纳入了28例(平均年龄57.9±13.8岁)患有DME的患者的30只眼。在基线和每次随访时进行了全面的眼科检查,包括最佳矫正视力(BCVA)测定、立体生物显微镜检查以及通过光学相干断层扫描(OCT)测量视网膜厚度。所有患者均接受了一次玻璃体内注射,注射量为0.05 mL,其中含有1.25 mg贝伐单抗。

结果

所有患者均完成了3个月的随访,平均随访期为5.26±2.39个月。基线时平均BCVA为0.73±0.36 logMAR,在1周、1个月和3个月时分别显著改善至0.63±0.41(p = 0.02)、0.58±0.36(p = 0.003)和0.61±0.40 logMAR(p = 0.006)。最终BCVA分析显示,15只眼(50%)保持稳定,12只眼(40%)的BCVA提高了≥2行。基线时平均中央视网膜厚度为498.96±123.99微米,在1周、1个月和3个月时分别降至359.06±105.97(p<0.001)、334.40±121.76(p<0.001)、421.40±192.76微米(p = 0.035)。未观察到眼部毒性或不良反应。

结论

玻璃体内注射贝伐单抗可使DME患者在注射后1周即出现BCVA和中央视网膜厚度的显著改善,且这种有益效果可持续长达3个月。然而,3个月时这种改善略有下降,提示可能需要重复注射贝伐单抗。为评估长期安全性和疗效,还需要进一步的前瞻性随机对照临床试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414e/2655742/22af09f61076/kjo-23-17-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414e/2655742/4aa9518498f3/kjo-23-17-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414e/2655742/95aa493844f0/kjo-23-17-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414e/2655742/22af09f61076/kjo-23-17-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414e/2655742/4aa9518498f3/kjo-23-17-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414e/2655742/95aa493844f0/kjo-23-17-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414e/2655742/22af09f61076/kjo-23-17-g003.jpg

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