Department of Ophthalmology, Peking University People's Hospital, Beijing, China.
Chin Med J (Engl). 2009 Nov 20;122(22):2695-9.
Branch retinal vein occlusion (BRVO) is a common retinal vascular disorder of the elderly and both intravitreal triamcinolone acetonide (TA) and intravitreal bevacizumab were reported to be effective. The purpose of this study was to compare intravitreal bevacizumab with intravitreal TA for the treatment of macular edema resulting from BRVO.
The retrospectively comparative interventional study included a bevacizumab group of 34 BRVO patients (1.25 mg bevacizumab) and a TA group of 34 BRVO patients (4.0 mg TA), and the two groups were matched by baseline best corrected visual acuity (BCVA). Examinations were designed to be carried out at 1 day, 3 days, 1 month, 2 months, 3 months, 6 months and 1 year after each injection. The mean follow-up was (148.43 +/- 130.56) days. Main outcome parameters were BCVA and morphometric measurements of the macula obtained by optical coherence tomography.
In all follow-ups, the mean changes of BCVA (LogMAR) between two groups were not significantly different (P > 0.10). Similarly, the rates of patients who got BCVA improvement > or = 2 lines or lost BCVA > or = 2 lines were not significantly different, either (P > 0.10). In both groups, compared with baseline, the mean central macular thickness (CMT) got reduction from 4 weeks to 1 year after initial injection, however, which lost statistical significance at 6-month follow-up in TA group (P = 0.25) and lost significance at 3-month and 6-month follow-up in bevacizumab group (P = 0.07, 0.21). The mean CMT between two groups differed at 3-month follow-up (P < 0.01), while almost kept parallel in other follow-ups (all P > 0.40). In TA group, retinal pigment epithelium tear occurred in 1 eye at 8 weeks after initial injection and 12 eyes (35.3%) got intraocular pressure > 21 mmHg. In bevacizumab group, no severe complications were observed.
For BRVO, intravitreal bevacizumab versus intravitreal TA causes a similar increase in visual acuity and reduction of macular edema (except 3-month follow-up) with minor complications during 1 year.
视网膜分支静脉阻塞（BRVO）是老年人常见的视网膜血管疾病，已有报道称玻璃体内曲安奈德（TA）和玻璃体内贝伐单抗均有效。本研究旨在比较玻璃体内贝伐单抗与玻璃体内 TA 治疗 BRVO 引起的黄斑水肿。
这是一项回顾性对比干预研究，纳入了 34 例 BRVO 患者的贝伐单抗组（1.25mg 贝伐单抗）和 34 例 BRVO 患者的 TA 组（4.0mg TA），两组患者在基线最佳矫正视力（BCVA）方面相匹配。检查设计在每次注射后 1 天、3 天、1 个月、2 个月、3 个月、6 个月和 1 年进行。平均随访时间为（148.43±130.56）天。主要观察指标为光学相干断层扫描（OCT）获得的黄斑形态和 BCVA。
在所有随访中，两组间 BCVA（LogMAR）的平均变化差异均无统计学意义（P＞0.10）。同样，BCVA 改善≥2 行或丧失≥2 行的患者比例也无统计学差异（P＞0.10）。两组患者在初始注射后 4 周至 1 年的平均中央黄斑厚度（CMT）均较基线下降，但 TA 组在 6 个月随访时（P=0.25）及贝伐单抗组在 3 个月和 6 个月随访时（P=0.07、0.21）差异无统计学意义。两组间的平均 CMT 在 3 个月时差异有统计学意义（P＜0.01），而在其他随访时间差异无统计学意义（均 P＞0.40）。在 TA 组，1 只眼在初始注射后 8 周发生视网膜色素上皮撕裂，12 只眼（35.3%）眼压＞21mmHg。在贝伐单抗组，未观察到严重并发症。
对于 BRVO，玻璃体内贝伐单抗与玻璃体内 TA 对视力的提高和黄斑水肿的减轻（除 3 个月随访外）效果相似，且在 1 年内并发症较少。
