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基于光学相干断层扫描的治疗方案对新生血管性年龄相关性黄斑变性应用玻璃体内注射贝伐单抗(阿瓦斯汀)的疗效:6 个月和 12 个月的结果。

Effect of intravitreal bevacizumab (Avastin) in neovascular age-related macular degeneration using a treatment regimen based on optical coherence tomography: 6- and 12-month results.

机构信息

Department of Ophthalmology, Medical University of Vienna, Austria.

出版信息

Acta Ophthalmol. 2010 Aug;88(5):594-600. doi: 10.1111/j.1755-3768.2008.01485.x. Epub 2009 May 22.

Abstract

PURPOSE

To study the effect of intravitreal bevacizumab therapy on visual and anatomical outcomes in patients with neovascular age-related macular degeneration (AMD) within a follow-up period of 6 and 12 months.

METHODS

A retrospective analysis of 102 eyes of 102 consecutive patients with neovascular AMD evaluated repeated intravitreal bevacizumab (1 or 2.5 mg) injections. Retreatment was performed following an optical coherence tomography (OCT)-based regimen. Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination and OCT imaging. Data were analysed at baseline, 6 months (24 weeks) and 12 months (48 weeks) after treatment initiation.

RESULTS

BCVA remained stable at 6 months (mean: 0.00+/-0.41 logMAR; p=0.95) and 12 months (mean: +0.02+/-0.43 logMAR; loss of approximately 1 letter; p=0.70) after the first treatment. OCT retinal thickness decreased by a mean of -37.8+/-101.6 microm (p<0.05) compared to baseline at month 6 and -38.6+/-93.3 microm (p<0.05) at month 12. A mean of 2.6+/-1.2 injections were needed to obtain absence of fluid by OCT, and the time to recurrence was 23+/-11 weeks thereafter. There was no difference in BCVA and OCT outcomes between treatment-naive eyes and eyes that had undergone prior treatment.

CONCLUSION

The 6- and 12-month follow-up of repeated intravitreal bevacizumab therapy in eyes with neovascular AMD demonstrated stabilization of vision and no safety concerns. An OCT-based retreatment strategy appears appropriate in the management of patients treated with intravitreal bevacizumab.

摘要

目的

研究玻璃体内注射贝伐单抗治疗新生血管性年龄相关性黄斑变性(AMD)患者在 6 个月和 12 个月的随访期内对视力和解剖学结果的影响。

方法

回顾性分析了 102 例 102 只连续患新生血管性 AMD 的患者的眼睛,这些患者接受了重复的玻璃体内注射贝伐单抗(1 或 2.5mg)。根据光学相干断层扫描(OCT)的方案进行再治疗。眼科检查包括最佳矫正视力(BCVA)、散瞳眼底检查和 OCT 成像。在治疗开始后的基线、6 个月(24 周)和 12 个月(48 周)时进行数据分析。

结果

在第一次治疗后 6 个月(平均:0.00+/-0.41 logMAR;p=0.95)和 12 个月(平均:+0.02+/-0.43 logMAR;损失约 1 个字母;p=0.70),BCVA 保持稳定。与基线相比,OCT 视网膜厚度在 6 个月时平均降低了-37.8+/-101.6 µm(p<0.05),在 12 个月时降低了-38.6+/-93.3 µm(p<0.05)。需要平均 2.6+/-1.2 次注射才能通过 OCT 消除液体,此后复发时间为 23+/-11 周。初次治疗和之前接受过治疗的眼睛之间,BCVA 和 OCT 结果没有差异。

结论

在新生血管性 AMD 患者中重复玻璃体内注射贝伐单抗的 6 个月和 12 个月随访显示,视力稳定,无安全性问题。基于 OCT 的再治疗策略似乎适用于接受玻璃体内贝伐单抗治疗的患者的管理。

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