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玻璃体内注射贝伐单抗治疗近视性脉络膜新生血管:一项前瞻性研究的第二年

Intravitreal bevacizumab for treatment of myopic choroidal neovascularization: the second year of a prospective study.

作者信息

Gharbiya M, Allievi F, Conflitti S, Esposito M, Scavella V, Moramarco A, Cruciani F

机构信息

Department of Ophthalmology, University of Rome La Sapienza, Rome, Italy.

出版信息

Clin Ter. 2010;161(3):e87-93.

Abstract

PURPOSE

To evaluate the efficacy and safety of intravitreal bevacizumab for the treatment of myopic choroidal neovascularization (CNV).

DESIGN

Prospective, non-randomized, interventional clinical study.

METHODS

Twenty eyes from 20 patients with CNV secondary to pathologic myopia participated in this study. These patients had already completed 12 months of follow-up. All patients were scheduled for 3 monthly intravitreal bevacizumab 1.25 mg injections. ETDRS best-corrected visual acuity (BCVA), foveal center thickness (FCT) on OCT and CNV size as assessed by fluorescein angiography were examined before and after treatment. Patients were followed up for 24 months.

RESULTS

Mean BCVA (+/- SD) at baseline was 24.8 (+/- 11.86) letters (Snellen equivalent: 20/80). At 24 months after treatment the mean BCVA (+/- SD) improved significantly (p less than 0.05) to 44 (+/- 13.99) letters (Snellen equivalent: 20/33). At 24 month follow-up, BCVA improved of 10 letters or more in 17 (85%) out of 20 treated eyes and improved of 15 letters or more in 15 (75%) eyes. No treated eyes experienced a worsening of BCVA from baseline. Mean foveal center thickness (FCT) (+/- SD) at baseline was 223 (+/- 47,43) microns. By month 24, mean FCT (+/-SD) reduced to 190 (+/- 29.01) microns (p less than 0.05). Mean area of the CNVs at baseline was 0.77 (+/- 0.78) mm2, which decreased to 0.31 +/- (0.51) mm2 and 0.30 (+/- 0.50) mm2 at 12 (p less than 0.05) and 24 months (p less than 0.05), respectively. At 24 months follow-up absence of fluoresce in leakage from the CNV was demonstrated in 18 (90%) out of 20 treated eyes. No ocular or systemic adverse effects from treatment were encountered.

CONCLUSION

Eyes with myopic CNV treated with intravitreal bevacizumab over 2 years had significant anatomic and functional improvement. Further studies will be needed to confirm the long-term efficacy and safety of this treatment.

摘要

目的

评估玻璃体内注射贝伐单抗治疗近视性脉络膜新生血管(CNV)的疗效和安全性。

设计

前瞻性、非随机、干预性临床研究。

方法

20例继发于病理性近视的CNV患者的20只眼参与本研究。这些患者已完成12个月的随访。所有患者计划每月3次玻璃体内注射1.25mg贝伐单抗。在治疗前后检查ETDRS最佳矫正视力(BCVA)、OCT上的黄斑中心厚度(FCT)以及荧光素血管造影评估的CNV大小。对患者进行24个月的随访。

结果

基线时平均BCVA(±标准差)为24.8(±11.86)字母(Snellen等效值:20/80)。治疗后24个月,平均BCVA(±标准差)显著改善(p<0.05)至44(±13.99)字母(Snellen等效值:20/33)。在24个月随访时,20只治疗眼中有17只(85%)的BCVA改善了10个字母或更多,15只(75%)眼的BCVA改善了15个字母或更多。没有治疗眼的BCVA从基线开始恶化。基线时平均黄斑中心厚度(FCT)(±标准差)为223(±47.43)微米。到第24个月时,平均FCT(±标准差)降至190(±29.01)微米(p<0.05)。基线时CNV的平均面积为0.77(±0.78)mm²,在12个月(p<0.05)和24个月(p<0.05)时分别降至0.31±(0.51)mm²和0.30(±0.50)mm²。在24个月随访时,20只治疗眼中有18只(90%)显示CNV无荧光素渗漏。未遇到治疗引起的眼部或全身不良反应。

结论

接受玻璃体内贝伐单抗治疗2年的近视性CNV眼在解剖和功能上有显著改善。需要进一步研究来证实这种治疗的长期疗效和安全性。

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