曲安奈德联合贝伐单抗玻璃体内注射治疗与年龄相关性黄斑变性相关的大视网膜色素上皮脱离的脉络膜新生血管。
Intravitreal injection of triamcinolone combined with bevacizumab for choroidal neovascularization associated with large retinal pigment epithelial detachment in age-related macular degeneration.
机构信息
Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Boulevard 9 avril 1006 Bab saadoun, Tunis, Tunisia.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2010 Jun;248(6):779-84. doi: 10.1007/s00417-010-1302-4. Epub 2010 Feb 19.
PURPOSE
To discuss the effect and outcome of a combined intravitreal triamcinolone acetonide (IVTA) injection with intravitreal bevacizumab (IVB) in treating choroidal neovascularization (CNV) associated with large retinal pigment epithelial detachment (PED) in age-related macular degeneration (AMD).
DESIGN
Prospective, consecutive, observational case series.
METHODS
Seven eyes (five patients) with CNV associated with large PED in AMD were treated by IVTA (4 mg/ 0.1 ml), followed by a IVB (1.25 mg/0.05 ml) 1 week later. Patients were evaluated for best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) at baseline, at 1 week and every 6 weeks. Fluorescein angiography (FA) and indocyanine green angiography (ICG) were performed at baseline and every 3 months afterwards. Indications for retreatment by combined injection were defined as persistent PED with subretinal and/or intraretinal fluid on OCT. Patients with flattening of the PED and activity leakage demonstrated by OCT underwent subsequent IVB.
RESULTS
The mean duration of follow-up was 11 months (range 9-14 months). BCVA at baseline averaged 20/125, and 20/80 at the end of follow-up. FA showed no leakage from the lesion in four eyes at the end of follow-up, and three eyes showed a decrease in leakage. Average central foveal thickness was (CFT) 325.7 microns at baseline and 209.2 microns at the end. The average size of the PED was 2.34 disk diameters (range 1.33-3.25) at baseline, and the PED disappeared in four eyes, while it decreased in size at the end in the remaining three. The subretinal fluid disappeared in all patients at the end. The combined treatment (IVTA with IVB 1 week later) was repeated in four eyes, and the number of IVB after combined injection ranged from one to three. No RPE tear appeared during follow-up. Two eyes developed glaucoma controlled by topical medication. There were no other ocular or systemic complications
CONCLUSION
Combined IVB and IVTA therapy seems to be an effective and safe procedure to treat CNV associated with large PED in AMD.
目的
探讨玻璃体内曲安奈德（IVTA）联合玻璃体内贝伐单抗（IVB）注射治疗年龄相关性黄斑变性（AMD）伴大视网膜色素上皮脱离（PED）的脉络膜新生血管（CNV）的疗效和结果。
设计
前瞻性、连续、观察性病例系列。
方法
7 只眼（5 例）AMD 伴大 PED 的 CNV 患者接受 IVTA（4mg/0.1ml）治疗，1 周后行 IVB（1.25mg/0.05ml）。患者在基线、1 周和每 6 周进行最佳矫正视力（BCVA）和光学相干断层扫描（OCT）评估。在基线和之后每 3 个月进行荧光素血管造影（FA）和吲哚青绿血管造影（ICG）。通过 OCT 显示 PED 持续存在伴视网膜下和/或视网膜内液体来确定联合注射的再治疗指征。PED 变平且 OCT 显示活性渗漏的患者随后接受 IVB。
结果
平均随访时间为 11 个月（9-14 个月）。基线时 BCVA 平均为 20/125，随访结束时为 20/80。4 只眼在随访结束时 FA 显示病变无渗漏，3 只眼渗漏减少。平均中央黄斑厚度（CFT）为基线时 325.7μm，随访结束时 209.2μm。PED 基线大小为 2.34 个视盘直径（范围 1.33-3.25），4 只眼 PED 消失，3 只眼 PED 缩小。所有患者的视网膜下液在随访结束时均消失。4 只眼接受了 IVTA 联合 IVB 治疗（1 周后），联合注射后的 IVB 次数为 1-3 次。随访期间无 RPE 撕裂。2 只眼发生青光眼，经局部药物治疗控制。无其他眼部或全身并发症。
结论
IVB 和 IVTA 联合治疗似乎是治疗 AMD 伴大 PED 的 CNV 的一种有效且安全的方法。
Zotero 插件