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玻璃体内注射贝伐单抗作为葡萄膜炎相关脉络膜新生血管的一线局部治疗:长期结果。

Intravitreal bevacizumab as first local treatment for uveitis-related choroidal neovascularization: long-term results.

机构信息

Department of Ophthalmology, Pitié-Salpêtrière Hospital, Paris, France.

出版信息

Acta Ophthalmol. 2011 Mar;89(2):179-84. doi: 10.1111/j.1755-3768.2010.02046.x.

Abstract

PURPOSE

To report long-term results of intravitreal (IVT) bevacizumab as first local treatment for choroidal neovascularization (CNV) secondary to uveitis.

METHODS

Files of patients receiving 1.25 mg/0.05 ml bevacizumab as primary local treatment for CNV were retrospectively reviewed. Main outcomes were change in best-corrected visual acuity (BCVA) and central foveolar thickness (CFT), treatment-related adverse events, and number and frequency of injections.

RESULTS

Fifteen eyes from fifteen patients were included. Multifocal choroiditis and panuveitis were the diagnosis in seven, ampiginous choroiditis in two, and for six remaining, serpiginous choroiditis, sympathetic ophthalmia, Vogt-Koyanagi-Harada syndrome, punctuate inner choroidopathy, tuberculosis and idiopathic inflammation. In 13 eyes, neovascularization was subfoveal, and peripapillary in two. Intraocular inflammation was strictly controlled in all cases by the time of injections. BCVA improved from logMar 0.53 to logMar 0.29 in 12 eyes (80%), while CFT decreased from 239.06 to 195.2 μm in 13 (87%). Twelve eyes received more than one injection; mean number in this group was 4.25 (2-8), and frequency 1 every 12.97 weeks. There were no adverse events related to bevacizumab or the procedure. Median follow-up was 17.6 months (8-25).

CONCLUSIONS

First-intention IVT bevacizumab for inflammatory CNV showed transient improvement in BCVA and CFT, in eyes under controlled inflammation. Reinjection was needed in most cases. Further work should conclude about safety related to repeated injections.

摘要

目的

报告玻璃体内(IVT)贝伐单抗作为葡萄膜炎继发脉络膜新生血管(CNV)的一线局部治疗的长期结果。

方法

回顾性分析接受 1.25mg/0.05ml 贝伐单抗作为 CNV 一线局部治疗的患者的档案。主要结局为最佳矫正视力(BCVA)和中心凹下脉络膜厚度(CFT)的变化、与治疗相关的不良反应、注射次数和频率。

结果

15 例 15 眼纳入研究。7 例为多发性脉络膜炎和全葡萄膜炎,2 例为匐行性脉络膜炎,6 例分别为匐行性脉络膜炎、交感性眼炎、Vogt-Koyanagi-Harada 综合征、点状内层脉络膜病变、结核和特发性炎症。13 只眼的新生血管位于中心凹下,2 只眼位于视盘旁。所有病例在注射时均严格控制眼内炎症。12 只眼(80%)的 BCVA 从 logMar 0.53 提高到 logMar 0.29,13 只眼(87%)的 CFT 从 239.06μm 降低到 195.2μm。12 只眼接受了一次以上的注射;该组的平均注射次数为 4.25(2-8),频率为每 12.97 周 1 次。没有与贝伐单抗或该手术相关的不良反应。中位随访时间为 17.6 个月(8-25)。

结论

在炎症得到控制的情况下,作为葡萄膜炎继发 CNV 的一线 IVT 贝伐单抗治疗可使 BCVA 和 CFT 短暂改善,但大多数患者需要再次注射。需要进一步研究重复注射的安全性。

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