Takamura Yoshihiro, Kubo Eri, Akagi Yoshio
Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui-ken, Japan.
Ophthalmology. 2009 Jun;116(6):1151-7. doi: 10.1016/j.ophtha.2009.01.014. Epub 2009 Apr 19.
To determine the feasibility and clinical effectiveness of intravitreal bevacizumab combined with cataract surgery for management of the postoperative increase of retinal thickness in patients with diabetic maculopathy.
Prospective, randomized, masked cohort study.
Forty-two eyes with diabetic macular edema (DME) of 42 patients with type 2 diabetes mellitus.
Patients were randomly assigned to receive either cataract surgery only (control; 21 eyes) or combined with intravitreal injection of 1.25 mg bevacizumab (21 eyes). Efficacy measures included best-corrected visual acuity (BCVA) testing, optical coherence tomography (OCT), and ophthalmoscopic examination.
Retinal thickness (RT) on OCT and BCVA were measured at baseline and 1 and 3 months after surgery.
There were no significant differences in RT, BCVA, severity of cataract, or systemic condition between the control and bevacizumab groups at the baseline. One and 3 months after surgery, the control group showed a significant increase in RT, whereas the bevacizumab group showed a significant decrease. Although postoperatively the eyes in both groups showed a significant improvement of BCVA, bevacizumab-treated eyes showed significantly better results (mean logarithm of the minimum angle of resolution, 0.38) than the control group (0.51) at month 3. There was a significant relationship between RT and visual acuity (VA) postoperatively in the control (P = 0.0001) and bevacizumab (P = 0.0141) groups. No systemic or ocular adverse events were observed.
Short-term results suggest that intravitreal bevacizumab has the potential not only to prevent the increase in RT, but also reduce the RT of eyes with DME after cataract surgery. Further improvement of VA in bevacizumab-treated eyes may be dependent on a reduction in central RT.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.
确定玻璃体内注射贝伐单抗联合白内障手术治疗糖尿病性黄斑病变患者术后视网膜厚度增加的可行性和临床疗效。
前瞻性、随机、盲法队列研究。
42例2型糖尿病患者的42只糖尿病性黄斑水肿（DME）眼。
患者被随机分配接受单纯白内障手术（对照组；21只眼）或联合玻璃体内注射1.25 mg贝伐单抗（21只眼）。疗效指标包括最佳矫正视力（BCVA）测试、光学相干断层扫描（OCT）和检眼镜检查。
在基线以及术后1个月和3个月测量OCT上的视网膜厚度（RT）和BCVA。
基线时，对照组和贝伐单抗组在RT、BCVA、白内障严重程度或全身状况方面无显著差异。术后1个月和3个月，对照组RT显著增加，而贝伐单抗组RT显著降低。虽然两组术后BCVA均有显著改善，但在第3个月时，接受贝伐单抗治疗的眼的结果（最小分辨角的平均对数，0.38）明显优于对照组（0.51）。对照组（P = 0.0001）和贝伐单抗组（P = 0.0141）术后RT与视力（VA）之间存在显著相关性。未观察到全身或眼部不良事件。
短期结果表明，玻璃体内注射贝伐单抗不仅有可能预防RT增加，还能降低白内障手术后DME眼的RT。贝伐单抗治疗的眼中VA的进一步改善可能取决于中央RT的降低。
作者对本文讨论的任何材料均无所有权或商业利益。
