El-Mollayess Georges M, Noureddine Baha' N, Bashshur Ziad F
The Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
Semin Ophthalmol. 2011 May;26(3):69-76. doi: 10.3109/08820538.2010.545100.
The pathogenesis of neovascular age related macular degeneration (AMD) is multifactorial including inflammation and angiogenesis leading to choroidal neovascularization (CNV). Therapy against vascular endothelial growth factor (VEGF) has revolutionized the treatment of neovascular AMD. Intravitreal off-label use of bevacizumab proved to be safe. This literature review was conducted to study improvement in visual acuity, change in central retinal thickness (CRT), safety, pharmacodynamics, and possible resistance to intravitreal bevacizumab over a one-year period in eyes with neovascular AMD. We reviewed articles between 1997 and January 2010 that included at least 30 patients with AMD who received intravitreal bevacizumab monotherapy for at least 1 year. The mean number of letters gained, decrease in CRT, and number of injections were 8 letters, 125.3 µm, and 4.3 injections, respectively. Further, randomized prospective clinical trials are needed to determine the efficacy and safety of intravitreal bevacizumab in the treatment of neovascular AMD.
新生血管性年龄相关性黄斑变性（AMD）的发病机制是多因素的，包括炎症和血管生成，进而导致脉络膜新生血管（CNV）。抗血管内皮生长因子（VEGF）疗法彻底改变了新生血管性AMD的治疗方式。玻璃体内使用未获批准的贝伐单抗被证明是安全的。进行这项文献综述是为了研究新生血管性AMD患者在一年时间内，玻璃体内注射贝伐单抗后视力的改善情况、中心视网膜厚度（CRT）的变化、安全性、药效学以及可能产生的耐药性。我们回顾了1997年至2010年1月期间的文章，这些文章纳入了至少30例接受玻璃体内贝伐单抗单药治疗至少1年的AMD患者。平均视力提高的字母数、CRT的降低值以及注射次数分别为8个字母、125.3 µm和4.3次注射。此外，还需要进行随机前瞻性临床试验来确定玻璃体内注射贝伐单抗治疗新生血管性AMD的疗效和安全性。
