Department of Ophthalmology, University of Missouri-Columbia, Columbia, MO, USA.
Can J Ophthalmol. 2011 Apr;46(2):182-5. doi: 10.3129/i10-095.
To evaluate visual outcomes of eyes with choroidal neovascular membrane secondary to age-related macular degeneration that were initially treated with intravitreal ranibizumab then switched to intravitreal bevacizumab due to treatment failure.
Retrospective chart review.
Fifty eyes of 50 patients presenting to the Barnes Retina Institute.
Patients unresponsive to treatment with intravitreal ranibizumab were switched to intravitreal bevacizumab. Main outcome measures included number of intravitreal injections, visual acuity (VA), and resolution of leakage. Mean follow-up was 6 months after the final intravitreal bevacizumab injection. On average, each patient received 3.5 ranibizumab injections and 2.5 bevacizumab injections. Each patient received an average of 6 injections.
Resolution of leakage on fluorescein angiography and optical coherence tomography was achieved in 44 eyes (88%). Initial VA ranged from 20/30 to counting fingers (CF) (median VA 20/125). Final VA ranged from 20/20 to CF (median VA 20/100). Change in VA varied from loss of 2 lines to gain of 4 lines, but overall, remained stable (average gain 0.3 lines). Eighteen eyes (36%) had a final VA of ≥ 20/50 and 18 eyes (36%) had a final VA of ≤20/200.
Treatment with intravitreal bevacizumab may be effective, as measured by visual and anatomic criteria, in patients who are unresponsive to treatment with intravitreal ranibizumab.
评估因治疗失败而从玻璃体内雷珠单抗治疗转换为玻璃体内贝伐单抗治疗的年龄相关性黄斑变性脉络膜新生血管膜眼的视力结果。
回顾性图表分析。
50 例 50 只眼，就诊于 Barnes 视网膜研究所。
对玻璃体内雷珠单抗治疗无反应的患者转换为玻璃体内贝伐单抗治疗。主要观察指标包括玻璃体内注射次数、视力和渗漏的缓解情况。平均随访时间为最后一次玻璃体内贝伐单抗注射后 6 个月。平均每位患者接受了 3.5 次雷珠单抗注射和 2.5 次贝伐单抗注射。每位患者平均接受了 6 次注射。
44 只眼（88%）的荧光素血管造影和光学相干断层扫描显示渗漏缓解。初始视力从 20/30 到指数（CF）（中位数视力 20/125）不等。最终视力从 20/20 到 CF 不等（中位数视力 20/100）。视力变化从丧失 2 行到增加 4 行不等，但总体保持稳定（平均增加 0.3 行）。18 只眼（36%）最终视力≥20/50，18 只眼（36%）最终视力≤20/200。
玻璃体内贝伐单抗治疗可能对玻璃体内雷珠单抗治疗无反应的患者有效，可通过视觉和解剖标准进行评估。
