三种治疗分支静脉阻塞性黄斑水肿的方法:玻璃体内注射贝伐单抗或组织型纤溶酶原激活剂,以及玻璃体切除术。
Three treatments for macular edema because of branch retinal vein occlusion: intravitreous bevacizumab or tissue plasminogen activator, and vitrectomy.
机构信息
Shinjo Ophthalmologic Institute, Mego Shimokitakata-machi, Miyazaki, Japan.
出版信息
Retina. 2012 Mar;32(3):520-9. doi: 10.1097/IAE.0b013e31822529e2.
PURPOSE
To evaluate the effectiveness of intravitreous bevacizumab (Avastin), intravitreous tissue plasminogen activator, and vitrectomy for the macular edema secondary to branch retinal vein occlusion.
METHODS
Retrospective, interventional case series. We studied 228 eyes of 228 patients. Forty-one eyes received 1.25 mg of intravitreous bevacizumab, 71 eyes received tissue plasminogen activator, and 116 eyes underwent vitrectomy. A reinjection of 1.25 mg of bevacizumab was based on the morphologic and functional findings. The main outcome measures were the best-corrected visual acuity and optical coherence tomography-determined foveal thickness.
RESULTS
The mean postoperative follow-up period was 32.2 months with a range of 12 months to 69 months. The mean number of intravitreous bevacizumab was 2.8 with a range of 1 to 5. The mean best-corrected visual acuity and foveal thickness significantly improved after all 3 treatments, and the differences in the best-corrected visual acuity between the 3 groups were not significant at 12 months. Fourteen eyes (34%) in the intravitreous bevacizumab group and 21 eyes (30%) in the tissue plasminogen activator group required additional surgeries.
CONCLUSION
The 3 treatments appear to provide similar visual outcomes at 12 months. However, in some eyes treated with intravitreous bevacizumab or tissue plasminogen activator, additional surgeries were required, and a longer follow-up period was required to determine the final outcome.
目的
评估玻璃体内注射贝伐单抗(阿瓦斯汀)、玻璃体内组织型纤溶酶原激活剂和玻璃体切除术治疗视网膜分支静脉阻塞引起的黄斑水肿的疗效。
方法
回顾性、干预性病例系列研究。我们研究了 228 例 228 只眼。41 只眼接受了 1.25mg 玻璃体内贝伐单抗治疗,71 只眼接受了组织型纤溶酶原激活剂治疗,116 只眼接受了玻璃体切除术。根据形态和功能发现,对贝伐单抗进行了 1.25mg 的再注射。主要观察指标是最佳矫正视力和光学相干断层扫描确定的黄斑中心凹厚度。
结果
平均术后随访时间为 32.2 个月,范围为 12 个月至 69 个月。玻璃体内贝伐单抗的平均注射次数为 2.8 次,范围为 1 至 5 次。所有 3 种治疗方法后平均最佳矫正视力和黄斑中心凹厚度均显著改善,治疗后 12 个月 3 组间最佳矫正视力差异无统计学意义。玻璃体内贝伐单抗组 14 只眼(34%)和组织型纤溶酶原激活剂组 21 只眼(30%)需要额外手术。
结论
3 种治疗方法在 12 个月时似乎提供了相似的视力结果。然而,在一些接受玻璃体内贝伐单抗或组织型纤溶酶原激活剂治疗的眼中,需要进行额外的手术,需要更长的随访时间来确定最终结果。