Rechtman Ehud, Stalmans Ingeborg, Glovinsky Joseph, Breusegem Christophe, Moisseiev Joseph, Van Calster Joachim, Harris Alon
Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel.
Clin Ophthalmol. 2011;5:37-44. doi: 10.2147/OPTH.S15810. Epub 2011 Jan 6.
To evaluate the effect of intravitreal (IVT) bevacizumab in neovascular age-related macular degeneration (AMD) on global choroidal hemodynamics, as measured by ocular pulse amplitude (OPA).
This was a two-center prospective study (Sheba Medical Center, Israel, and University Hospitals Leuven, Belgium). AMD patients who required IVT bevacizumab (1.25 mg/0.05 mL; first or repeated) were examined three times: at days 0 (prior to injection), 7 (±3), and 28 (±7) postinjection. At each visit, OPAs of both eyes were measured using the Pascal dynamic contour tonometer (DCT). A paired t-test between preoperative and postoperative OPA was conducted. Pearson correlation was used to evaluate the influence of various measured parameters on DCT-OPA.
A total of 38 neovascular AMD patients were recruited, and 30 patients were included in the final analysis (18 females and 12 males; age 78.8 ± 5.82 years [mean ± standard deviation]). A good correlation was found throughout the study between the DCT-intraocular pressure (IOP) and Goldmann IOP and between DCT-IOP and DCT-OPA. No change in OPA of bevacizumab-treated eyes was found between the visits (2.24 ± 0.73, 2.2 ± 0.86, and 2.23 ± 0.73 mm Hg at visits 1, 2, and 3, respectively; paired t-test: P = 0.77 between visits 1 and 2, P = 0.98 between visits 1 and 3). No correlations were found between DCT-OPA and age, heart rate, systemic blood pressure, axial length, keratometry readings, and central corneal thickness.
OPA, an indirect measure of global choroidal hemodynamics, remains unchanged following IVT off-label bevacizumab. This finding adds to the growing evidence regarding the safety profile of bevacizumab in AMD treatment.
通过眼脉搏振幅（OPA）测量，评估玻璃体内（IVT）注射贝伐单抗治疗新生血管性年龄相关性黄斑变性（AMD）对整体脉络膜血流动力学的影响。
这是一项双中心前瞻性研究（以色列的舍巴医疗中心和比利时的鲁汶大学医院）。需要IVT注射贝伐单抗（1.25毫克/0.05毫升；首次或重复注射）的AMD患者接受三次检查：注射前第0天、注射后第7天（±3天）和第28天（±7天）。每次就诊时，使用帕斯卡动态轮廓眼压计（DCT）测量双眼的OPA。对术前和术后的OPA进行配对t检验。采用Pearson相关性分析评估各种测量参数对DCT-OPA的影响。
共招募了38例新生血管性AMD患者，最终纳入分析30例患者（18例女性和12例男性；年龄78.8±5.82岁[平均值±标准差]）。在整个研究中，DCT眼压（IOP）与戈德曼眼压之间以及DCT-IOP与DCT-OPA之间均发现良好相关性。在各次就诊之间，贝伐单抗治疗眼的OPA未发现变化（分别在第1、2和3次就诊时为2.24±0.73、2.2±0.86和2.23±0.73毫米汞柱；配对t检验：第1次和第2次就诊之间P=0.77，第1次和第3次就诊之间P=0.98）。未发现DCT-OPA与年龄、心率、全身血压、眼轴长度、角膜曲率读数和中央角膜厚度之间存在相关性。
OPA作为整体脉络膜血流动力学的间接测量指标，在IVT非标签使用贝伐单抗后保持不变。这一发现进一步证明了贝伐单抗在AMD治疗中的安全性。
