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玻璃体内注射贝伐单抗后脉络膜新生血管形态的变化:对156只眼进行12个月随访的前瞻性试验。

Changes in neovascular choroidal morphology after intravitreal bevacizumab injection: prospective trial on 156 eyes throughout 12-month follow-up.

作者信息

Costagliola Ciro, Semeraro Francesco, Cipollone Ugo, Rinaldi Michele, della Corte Michele, Romano Mario R

机构信息

Dipartimento di Scienze per la Salute, Università degli Studi del Molise, Campobasso, Italy.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2009 Aug;247(8):1031-7. doi: 10.1007/s00417-009-1081-y. Epub 2009 Apr 29.

Abstract

BACKGROUND

To report 12-month follow-up results of 156 eyes treated with anti-VEGF for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration, and to verify the efficacy of this treatment in terms of functional results and changes of morphology of choroidal membrane for the different types of choroidal neovascularization analyzed.

METHODS

This prospective case series study included subjects with different forms of subfoveal CNV. After the first intravitreal injection of 1.25 mg bevacizumab at baseline, re-injections of bevacizumab were scheduled at least 4 weeks after initial treatment following standardized criteria.

RESULTS

One hundred and fifty six patients were divided into two study groups: 60 eyes with classic CNV (group C) and 96 eyes with occult CNV (group O). The improvement in BCVA was greater in group C than group O, although the difference was not statistically significant (P = 0.26). The area of CNV and subretinal fibrous tissue/disciform scar remained stable over time in both groups. The macular thickness significantly decreased through the follow-up period in both groups. The hyper-reflective area of the neovascular complex remained stable in both groups during the first 6 months of follow-up, whereas a slight increase of hyper-reflective lesion size occurred throughout the second 6 months of follow-up.

CONCLUSION

The CNV lesion treated with IVB didn't disappear in neither group, but showed less exudation, demonstrated by a decrease in the area of leakage from CNV, subretinal fluid area, and centre point retinal thickness on OCT.

摘要

背景

报告156只眼接受抗血管内皮生长因子(VEGF)治疗年龄相关性黄斑变性继发的黄斑下脉络膜新生血管(CNV)的12个月随访结果,并根据不同类型脉络膜新生血管的功能结果和脉络膜膜形态变化验证该治疗的疗效。

方法

这项前瞻性病例系列研究纳入了不同形式黄斑下CNV的受试者。在基线时首次玻璃体内注射1.25mg贝伐单抗后,根据标准化标准在初始治疗后至少4周安排再次注射贝伐单抗。

结果

156例患者分为两个研究组:60只眼为典型CNV(C组),96只眼为隐匿性CNV(O组)。C组最佳矫正视力(BCVA)的改善大于O组,尽管差异无统计学意义(P = 0.26)。两组中CNV和视网膜下纤维组织/盘状瘢痕的面积随时间保持稳定。两组在随访期间黄斑厚度均显著降低。在随访的前6个月,两组新生血管复合体的高反射区均保持稳定,但在随访的后6个月,高反射病变大小略有增加。

结论

两组接受玻璃体内注射贝伐单抗(IVB)治疗的CNV病变均未消失,但渗出减少,这通过CNV渗漏面积、视网膜下液面积和光学相干断层扫描(OCT)上的视网膜中心厚度降低得以证明。

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