Shin Yong Woon, Lee Yoon Jung, Lee Byung Rho, Cho Hee Yoon
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2009 Dec;23(4):266-72. doi: 10.3341/kjo.2009.23.4.266. Epub 2009 Dec 4.
To investigate the short-term effects of panretinal photocoagulation (PRP) combined with an intravitreal injection of Avastin(bevacizumab) as an adjuvant to high-risk proliferative diabetic retinopathy (PDR).
The data was collected retrospectively from the eyes of high-risk PDR patients, which were divided into two groups. One eye was treated with only PRP (PRP only group) and the fellow eye of same patient was treated with both PRP and intravitreal bevacizumab injection (Adjuvant group). Best corrected visual acuity (BCVA), IOP (intraocular pressure), and new vessel (NV) size in fluorescein angiography were recorded immediately and at the six-week follow-up visit. Adverse events associated with intravitreal injection were investigated.
Of 12 patients with high-risk PDR, five were male and seven were female. There were no statistically significant BCVA or IOP changes after treatment in either group (p=0.916, 0.888). The reduction of NV size was found in both groups, but NV size in the adjuvant group showed a greater decrease than that of the PRP only group (p=0.038). Three patients had adverse events after intravitreal injection. Two patients had mild anterior uveitis and one patient had a serious complication of branched retinal artery obstruction (BRAO).
Intravitreal bevacizumab injection with PRP resulted in marked regression of neovascularization compared with PRP alone. One serious side effect, BRAO, was noted in this study. Further studies are needed to determine the effect of repeated intravitreal bevacizumab injections and the proper number of bevacizumab injections as an adjuvant.
探讨全视网膜光凝（PRP）联合玻璃体内注射阿瓦斯汀（贝伐单抗）作为高危增殖性糖尿病视网膜病变（PDR）辅助治疗的短期效果。
回顾性收集高危PDR患者眼部的数据，将患者分为两组。一只眼仅接受PRP治疗（单纯PRP组），同一名患者的另一只眼接受PRP联合玻璃体内贝伐单抗注射治疗（辅助治疗组）。在治疗后即刻及六周随访时记录最佳矫正视力（BCVA）、眼压（IOP）以及荧光素血管造影中的新生血管（NV）大小。调查与玻璃体内注射相关的不良事件。
12例高危PDR患者中，男性5例，女性7例。两组治疗后BCVA和IOP变化均无统计学意义（p = 0.916，0.888）。两组NV大小均有减小，但辅助治疗组NV大小的减小幅度大于单纯PRP组（p = 0.038）。3例患者在玻璃体内注射后出现不良事件。2例患者发生轻度前葡萄膜炎，1例患者出现视网膜分支动脉阻塞（BRAO）这一严重并发症。
与单纯PRP相比，PRP联合玻璃体内注射贝伐单抗可使新生血管明显消退。本研究中发现了一种严重副作用，即BRAO。需要进一步研究以确定重复玻璃体内注射贝伐单抗的效果以及作为辅助治疗时贝伐单抗的合适注射次数。
