Department of Health Sciences, University of Molise, Campobasso, Italy.
Retina. 2009 Oct;29(9):1227-34. doi: 10.1097/IAE.0b013e3181b773e1.
The aim of this study was to assess the 12-month efficacy of intravitreal bevacizumab (IVB) injection for occult choroidal neovascularization secondary to age-related macular degeneration.
In this retrospective, interventional case series, 68 treatment-naïve patients with age-related macular degeneration, affected by subfoveal occult choroidal neovascularization showing recent disease progression, were monitored during the IVB protocol. The patients received 1 initial IVB injection (1.25 mg/0.05 mL), and they underwent further retreatment on a monthly basis only when necessary, according to a standardized as-required regimen, until no significant signs of choroidal neovascularization activity were present. Main outcome measures were the modifications in best-corrected visual acuity and in central retinal thickness measured by optical coherence tomography.
With respect to baseline, at the 12-month check, mean best-corrected visual acuity increased from 0.82 to 0.45 logMAR (P < 0.01) and mean central retinal thickness decreased from 517.0 microm to 306.5 microm (P < 0.01). To achieve these benefits, the required mean IVB number was lowered from 3.87 in the first 6 months to 1.085 in the second 6 months. A better final best-corrected visual acuity was correlated with greater best-corrected visual acuity (P < 0.005) and lesser central retinal thickness (P < 0.05) at baseline.
In patients with age-related macular degeneration complicated by progressive occult choroidal neovascularization, first-line IVB administration represents a useful therapeutic option, especially considering its lower cost in comparison with other antiangiogenic drugs.
本研究旨在评估玻璃体内注射贝伐单抗（IVB）治疗年龄相关性黄斑变性继发隐匿性脉络膜新生血管的 12 个月疗效。
在这项回顾性、干预性病例系列研究中，68 例未经治疗的年龄相关性黄斑变性患者，其黄斑下隐匿性脉络膜新生血管伴有近期疾病进展，在 IVB 方案中接受监测。患者接受 1 次初始 IVB 注射（1.25mg/0.05ml），仅在必要时根据标准化按需方案每月进行进一步治疗，直到没有明显的脉络膜新生血管活动迹象。主要观察指标是最佳矫正视力和光学相干断层扫描测量的中心视网膜厚度的变化。
与基线相比，在 12 个月的检查时，平均最佳矫正视力从 0.82 提高到 0.45 对数视力（P<0.01），平均中心视网膜厚度从 517.0μm 降低到 306.5μm（P<0.01）。为了获得这些益处，所需的平均 IVB 数量从第 1 至 6 个月的 3.87 降至第 2 至 6 个月的 1.085。更好的最终最佳矫正视力与更大的最佳矫正视力（P<0.005）和更小的中心视网膜厚度（P<0.05）相关。
在患有进展性隐匿性脉络膜新生血管的年龄相关性黄斑变性患者中，一线 IVB 给药是一种有用的治疗选择，尤其是考虑到与其他抗血管生成药物相比其成本更低。
