Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany.
J Ocul Pharmacol Ther. 2010 Feb;26(1):79-83. doi: 10.1089/jop.2009.0095.
To analyze the long-term effect of multiple intravitreal injections of bevacizumab as therapy of exudative age-related macular degeneration (AMD).
The retrospective clinical interventional case series study included 45 patients (48 eyes) who received intravitreal injections of bevacizumab (1.5 mg) for treatment of exudative AMD and for whom the follow-up was >2 years. All patients received an initial series of 3 injections applied in intervals of 6-8 weeks. Subsequent injections were given in intervals ranging between 2 and 6 months. The mean number of all injections performed per eye was 8.6 +/- 2.5. The mean follow-up was 27.8 +/- 3.6 months. The main outcome parameters were best-corrected visual acuity (BCVA) and foveal thickness measurements by optical coherence tomography (OCT).
Mean BCVA improved from 0.62 +/- 0.30 LogMAR at baseline to 0.55 +/- 0.28 LogMAR (P = 0.03) at 1 month after the 3 initial injections. At the end of follow-up, BCVA decreased significantly (P = 0.02) to 0.76 +/- 0.41 LogMAR. Bivariate correlation tests showed that the change in BCVA from baseline to the final examination at the end of follow-up was significantly associated only with the baseline BCVA (correlation coefficient r = 0.39, P = 0.006). The height of the subretinal fluid reduced significantly (P = 0.004) at 1 month after the 3 initial injections and remained so till the final follow-up (P = 0.01).
Multiple intravitreal bevacizumab injections initially led to an improvement in visual acuity, finally, however, failed to stabilize visual acuity after a follow-up of >2 years.
分析多次玻璃体内注射贝伐单抗治疗渗出性年龄相关性黄斑变性（AMD）的长期效果。
这项回顾性临床干预性病例系列研究纳入了 45 名（48 只眼）接受玻璃体内注射贝伐单抗（1.5mg）治疗渗出性 AMD 的患者，这些患者的随访时间超过 2 年。所有患者均接受了初始的 3 次注射系列治疗，间隔 6-8 周。随后的注射间隔为 2-6 个月。每只眼的平均注射次数为 8.6±2.5 次。平均随访时间为 27.8±3.6 个月。主要观察指标是最佳矫正视力（BCVA）和光学相干断层扫描（OCT）测量的黄斑中心凹厚度。
平均 BCVA 从基线时的 0.62±0.30 LogMAR 提高到 3 次初始注射后 1 个月时的 0.55±0.28 LogMAR（P=0.03）。在随访结束时，BCVA 显著下降（P=0.02）至 0.76±0.41 LogMAR。双变量相关检验显示，从基线到随访结束时最终检查的 BCVA 变化仅与基线 BCVA 显著相关（相关系数 r=0.39，P=0.006）。在 3 次初始注射后 1 个月时，视网膜下液高度显著降低（P=0.004），并一直持续到最终随访（P=0.01）。
多次玻璃体内注射贝伐单抗最初可提高视力，但在超过 2 年的随访后，视力最终未能稳定。
