Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Eye (Lond). 2010 Oct;24(10):1535-41; quiz 1542. doi: 10.1038/eye.2010.113. Epub 2010 Sep 24.
The aim of this study is to evaluate the long-term efficacy of intravitreal bevacizumab (IVB) for eyes with non-proliferative idiopathic macular telangiectasia type 2 (IMT2) and acute vision loss.
In this interventional case series, treatment-naive eyes of 13 consecutive patients with IMT2 were included. Eyes with a recent onset of visual loss were treated with 0.04 ml IVB (n=7). Fellow eyes and eyes of patients without disease progression served as control group (CG) (n=12). Follow-up examinations included ophthalmoscopy, best-corrected visual acuity (BCVA), optical coherence tomography, and fluorescein angiography (FA).
Mean follow-up time was 32±5.7 months in the treatment group (TG) (n=7) vs 29±8.8 months in the CG (n=16). Mean BCVA increased from logMAR 0.47±0.32 at baseline to logMAR 0.33±0.31 (P=0.21) at the last visit in the TG and decreased from logMAR 0.25±0.39 to logMAR 0.30±0.40 in the CG (P=0.17). All patients in the TG showed stabilisation or improvement in vision in Snellen lines in contrast to the CG (χ(2)-test P=0.04). Patients received on average 2.3±1.3 IVB injections. Mean central millimetre thickness in TG and CG was 260±83 and 201±32 μm at baseline vs 237±69 and 199±29 μm at the last visit, respectively (P=0.23 and 0.77). FA revealed a significant decrease of the juxtafoveal staining size at month 3 (P= 0.004) and a slight reduction at the last visit (P= 0.11) in the TG.
Despite an overall moderate effect of IVB treatment, individual patients experience a marked functional and morphological long-term benefit.
本研究旨在评估玻璃体内注射贝伐单抗（IVB）治疗非增生性特发性黄斑毛细血管扩张症 2 型（IMT2）伴急性视力丧失的长期疗效。
这是一项干预性病例系列研究，纳入了 13 例连续的 IMT2 初治患者的治疗眼。7 例新近发生视力丧失的眼接受了 0.04ml IVB 治疗（治疗组，TG）。其余 12 例患者的对侧眼或无疾病进展的眼作为对照组（CG）。随访检查包括眼底镜检查、最佳矫正视力（BCVA）、光学相干断层扫描和荧光素血管造影（FA）。
TG（n=7）的平均随访时间为 32±5.7 个月，CG（n=16）为 29±8.8 个月。TG 的 BCVA 从基线时的 logMAR 0.47±0.32 提高至末次随访时的 logMAR 0.33±0.31（P=0.21），CG 则从 logMAR 0.25±0.39 降低至 logMAR 0.30±0.40（P=0.17）。与 CG 相比，TG 中的所有患者在 Snellen 视力表上的视力稳定或提高（卡方检验，P=0.04）。TG 患者平均接受了 2.3±1.3 次 IVB 注射。TG 和 CG 的平均中央毫米厚度在基线时分别为 260±83μm 和 201±32μm，末次随访时分别为 237±69μm 和 199±29μm（P=0.23 和 0.77）。FA 显示，TG 中在第 3 个月时（P=0.004）和末次随访时（P=0.11）的近黄斑区染色面积显著减少。
尽管 IVB 治疗的总体效果中等，但个别患者的功能和形态学长期获益显著。
