Cheema Rizwan A, Mushtaq Javed, Cheema Maheera A
Department of Vitreo-retinal service, Dhahran Eye Specialist Hospital, Dhahran, KSA.
Middle East Afr J Ophthalmol. 2011 Jul;18(3):220-3. doi: 10.4103/0974-9233.84051.
To report long-term outcomes of the use of intravitreal bevacizumab in subjects with idiopathic choroidal neovascularization (ICNV).
Six consecutive subjects with ICNV were included in this prospective study. All subjects received 1.25 mg intravitreal bevacizumab at diagnosis. A decrease in best corrected visual acuity (BCVA), presence of increased retinal edema or hemorrhage, increased retinal thickness on optical coherence tomography (OCT) or increased leakage documented by fluorescein angiography prompted further injections of bevacizumab.
The study cohort was comprised of 3 males and 3 females with a mean age of 31.17 years. Mean follow-up was 13.8 months (range, 8 months to 20 months). Following intravitreal bevacizumab injection, vision improved in 3 subjects, remained stable in 3 subjects and no patient lost visual acuity. The mean BCVA improved to logMAR 0.20 at final follow-up from baseline at 0.950 logMAR (P=0.031). The mean central macular thickness and central foveal thickness at the last postoperative visits were reduced from pre-treatment levels of 374.33 ± 146.52 and 347.16 ± 213.97 to 251.20±35.36 and 215.33 ± 43.94 μm, respectively. (P = 0.99 and P = 0.16, respectively). Four subjects required repeat treatments. The total number of repeat treatments was 4. Two subjects required no repeat injections, 3 subjects had 1 retreatment and one subject required 2 additional treatments. The injections were well tolerated by all the subjects, with no ocular or systemic adverse events.
Intravitreal injection of 1.25 mg bevacizumab in patients with ICNV is effective in improving and stabilizing vision. Additional studies, particularly determination of optimal protocol for timing of re-injection are required to assess long-term effects.
报告玻璃体内注射贝伐单抗治疗特发性脉络膜新生血管（ICNV）患者的长期疗效。
本前瞻性研究纳入了6例连续的ICNV患者。所有患者在诊断时接受1.25mg玻璃体内贝伐单抗注射。最佳矫正视力（BCVA）下降、视网膜水肿或出血增加、光学相干断层扫描（OCT）显示视网膜厚度增加或荧光素血管造影显示渗漏增加提示需进一步注射贝伐单抗。
研究队列包括3名男性和3名女性，平均年龄31.17岁。平均随访时间为13.8个月（范围8个月至20个月）。玻璃体内注射贝伐单抗后，3例患者视力改善，3例患者视力稳定，无患者视力丧失。最终随访时平均BCVA从基线时的logMAR 0.950提高到logMAR 0.20（P=0.031）。术后最后一次随访时，平均中心黄斑厚度和中心凹厚度分别从治疗前的374.33±146.52和347.16±213.97μm降至251.20±35.36和215.33±43.94μm。（P值分别为0.99和0.16）。4例患者需要重复治疗。重复治疗的总数为4次。2例患者无需重复注射，3例患者接受1次再治疗，1例患者需要额外2次治疗。所有患者对注射耐受性良好，无眼部或全身不良事件。
玻璃体内注射1.25mg贝伐单抗治疗ICNV患者可有效改善和稳定视力。需要进一步研究，尤其是确定再次注射的最佳时间方案，以评估长期疗效。
