Department of Ophthalmology, Hospital São João, Porto, Portugal.
Retina. 2010 Jan;30(1):85-92. doi: 10.1097/IAE.0b013e3181c700a9.
The purpose of this study was to elucidate the effect of prior photodynamic therapy (PDT) on the efficacy of intravitreal bevacizumab for the treatment of neovascular age-related macular degeneration.
One hundred and nine eyes of 102 patients with neovascular age-related macular degeneration were evaluated-80 eyes without prior treatment (group 1) and 29 with prior PDT (group 2). Best-corrected visual acuity, ocular coherence tomography, and funduscopy were assessed monthly. Results were evaluated at 1, 3, 6, and 12 months.
One hundred and one eyes completed a 12-month evaluation. At 12 months, best-corrected visual acuity increased 5.6 letters with treatment (P = 0.001): +5.7 letters in group 1 and +5.4 in group 2 (P = 0.92). Overall, visual acuity improved > or =15 letters in 22.5% of eyes: 24.0% of naive eyes versus 18.5% with prior PDT (P = 0.56). Best-corrected visual acuity loss > or =15 letters occurred in 6 eyes, 5 with naive lesions. An overall reduction in ocular coherence tomography central retinal thickness was observed at all time points. Mean number of injections per eye per year was 5.6, 6.13 in group 1 versus 4.22 in group 2 (P = 0.01). Two retinal pigment epithelial tears, one subretinal macular hemorrhage, and two strokes occurred in naive lesions.
The authors showed similar efficacy for intravitreal bevacizumab independently of prior PDT treatment. Eyes with prior PDT needed a statistically significantly lower number of injections to control their lesions.
本研究旨在阐明光动力疗法(PDT)对玻璃体内贝伐单抗治疗新生血管性年龄相关性黄斑变性疗效的影响。
评估了 102 例新生血管性年龄相关性黄斑变性患者的 109 只眼-80 只未经治疗的眼(第 1 组)和 29 只接受过 PDT 的眼(第 2 组)。每月评估最佳矫正视力、眼相干断层扫描和眼底检查。结果在 1、3、6 和 12 个月时进行评估。
101 只眼完成了 12 个月的评估。在 12 个月时,治疗后最佳矫正视力增加了 5.6 个字母(P = 0.001):第 1 组增加了 5.7 个字母,第 2 组增加了 5.4 个字母(P = 0.92)。总体而言,22.5%的眼视力提高了≥15 个字母:未经治疗的眼为 24.0%,接受过 PDT 的眼为 18.5%(P = 0.56)。6 只眼视力丧失≥15 个字母,其中 5 只为单纯病变。所有时间点均观察到眼相干断层扫描中央视网膜厚度的整体降低。平均每年每只眼的注射次数为 5.6 次,第 1 组为 6.13 次,第 2 组为 4.22 次(P = 0.01)。2 例单纯病变出现视网膜色素上皮撕裂、1 例脉络膜下视网膜出血和 2 例中风。
作者表明,玻璃体内贝伐单抗的疗效相似,与先前的 PDT 治疗无关。先前接受 PDT 治疗的眼需要注射的次数明显减少,以控制其病变。