Couch Steven M, Bakri Sophie J
Mayo Clinic, Department of Ophthalmology, Rochester, MN 55905, USA.
Semin Ophthalmol. 2011 May;26(3):114-20. doi: 10.3109/08820538.2011.577130.
While angiogenesis is one of the factors associated with the development of CNV due to age-related macular degeneration (AMD), inflammation and oxidative stress also appear to play a role. Treatment of CNV with intravitreal anti-vascular endothelial growth factor monotherapy is currently the standard of care. However, not all patients respond to monotherapy, and combination therapy may target the CNV through multiple mechanisms, thus reducing treatment frequency or improving visual outcome. Photodynamic therapy (with regular or reduced fluence), as well as intravitreal steroids are used in combination with anti-VEGF therapy. This paper reviews the many clinical trials that have been performed utilizing several combinations of double and triple therapy. While combination therapy is biologically justifiable, further study is required to determine correct combinations and dosage.
虽然血管生成是与年龄相关性黄斑变性（AMD）所致脉络膜新生血管（CNV）发展相关的因素之一，但炎症和氧化应激似乎也起作用。玻璃体内抗血管内皮生长因子单药治疗CNV目前是标准治疗方法。然而，并非所有患者对单药治疗都有反应，联合治疗可能通过多种机制靶向CNV，从而减少治疗频率或改善视力结果。光动力疗法（常规或降低能量密度）以及玻璃体内注射类固醇与抗VEGF治疗联合使用。本文综述了利用几种双联和三联疗法组合进行的众多临床试验。虽然联合治疗在生物学上是合理的，但仍需要进一步研究以确定正确的组合和剂量。
