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玻璃体内注射贝伐单抗治疗渗出性年龄相关性黄斑变性后的微视野变化。

Microperimetric changes after intravitreal bevacizumab injection for exudative age-related macular degeneration.

机构信息

The Istanbul Retina Institute, Istanbul, Turkey.

出版信息

Acta Ophthalmol. 2012 Feb;90(1):71-5. doi: 10.1111/j.1755-3768.2009.01838.x. Epub 2010 Feb 16.

Abstract

PURPOSE

To evaluate the effect of intravitreal bevacizumab on macular function in the cases of exudative age-related macular degeneration (AMD).

METHODS

A total of 21 eyes of 21 patients with exudative AMD were included in this study. In each eye, at baseline and 1, 3 and 6 months after intravitreal bevacizumab injection, logMAR visual acuity, central 4° macular sensitivity, absolute scotoma size, fixation stability and fixation location by MP-1 microperimetry and optical coherence tomography (OCT) foveal morphologic changes were assessed. After the initial treatment phase which included three consecutive injections, the decision to re-treat was based on OCT and clinical findings. Subsequent injections could be administered at least 1 month after the previous injection period according to the OCT-guided treatment regimen.

RESULTS

Mean retinal sensitivity within central 4° (12 points) area had increased from 3.69 ± 3.44 dB at baseline to 7.16 ± 3.27 dB at month 6. In all controls after the treatment, there was significant increase in logMAR visual acuity (p < 0.001) and MP-1 retinal sensitivity (p < 0.001). Mean absolute scotoma in test point location had decreased significantly from 12 of the 76 applied test point locations measured at baseline to five test point locations (-7 test point locations; p < 0.001) at month 6 showing statistical significance. Fixation properties had preserved in all patients 6 months after intravitreal bevacizumab treatment.

CONCLUSION

Intravitreal bevacizumab therapy induced a significant increase in mean retinal sensitivity and significant decrease in mean absolute scotoma size during 6 months. The MP1 microperimetry proved to be a valuable tool in the evaluation of functional benefit of exudative AMD therapy with intravitreal bevacizumab.

摘要

目的

评估玻璃体内注射贝伐单抗对渗出性年龄相关性黄斑变性(AMD)患者黄斑功能的影响。

方法

本研究共纳入 21 例 21 只眼渗出性 AMD 患者。每只眼在基线和玻璃体内注射贝伐单抗后 1、3 和 6 个月,分别评估 logMAR 视力、中央 4°黄斑敏感性、绝对暗点大小、MP-1 微视野的固视稳定性和固视位置以及光学相干断层扫描(OCT)黄斑形态变化。初始治疗阶段包括连续 3 次注射后,根据 OCT 和临床发现决定是否再次治疗。根据 OCT 指导的治疗方案,在之前的注射期至少 1 个月后可以进行后续注射。

结果

中央 4°(12 点)区域内平均视网膜敏感性从基线时的 3.69 ± 3.44 dB 增加到第 6 个月时的 7.16 ± 3.27 dB。所有治疗后对照者的 logMAR 视力(p < 0.001)和 MP-1 视网膜敏感性(p < 0.001)均有显著提高。在第 6 个月时,测量的 76 个测试点中有 12 个测试点位置的平均绝对暗点显著减少(-7 个测试点位置;p < 0.001)。所有患者在玻璃体内注射贝伐单抗治疗后 6 个月内保留了固视特性。

结论

玻璃体内注射贝伐单抗治疗在 6 个月内可显著提高平均视网膜敏感性,显著减少平均绝对暗点大小。MP1 微视野在评估玻璃体内注射贝伐单抗治疗渗出性 AMD 的功能获益方面是一种有价值的工具。

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