曲安奈德和贝伐单抗玻璃体腔注射治疗视网膜分支静脉阻塞所致黄斑水肿的前瞻性比较。

Prospective comparisons of intravitreal injections of triamcinolone acetonide and bevacizumab for macular oedema due to branch retinal vein occlusion.

机构信息

Department of Ophthalmology, Shiga University of Medical Science, Shiga, Japan.

出版信息

Acta Ophthalmol. 2013 Jun;91(4):318-24. doi: 10.1111/j.1755-3768.2011.02298.x. Epub 2011 Dec 1.

Abstract

PURPOSE

To compare the efficacy of intravitreal injections of triamcinolone acetonide (TA) and that of bevacizumab for macular oedema because of branch retinal vein occlusion (BRVO).

DESIGN

Prospective, comparative, randomized, interventional clinical trial.

METHODS

Forty-three eyes of 43 patients with macular oedema because of BRVO were randomly assigned to 4-mg intravitreal injections of TA (IVTA)(21 patients, IVTA group) or 1.25-mg intravitreal injections of bevacizumab (IVB) (22 patients, IVB group) and followed for 12 months. No additional treatments were administered for 3 months after the initial injection; additional injections were administered when macular oedema recurred between 3 and 12 months after the initial injection. The best-corrected visual acuity (BCVA) and the central retinal thickness (CRT) were measured at baseline and monthly. The main outcome measures were changes in the logarithm of the minimal angle of resolution BCVA and CRT from baseline to 12 months.

RESULTS

Eighteen eyes of 18 patients in the IVTA group and 18 eyes of 18 patients in the IVB group completed follow-up at 12 months. The mean improvements in BCVA from baseline to 12 months were 0.12 in the IVTA group and 0.33 in the IVB group, which was significantly (p = 0.032) higher than in the IVTA group. There was no significant difference between the two groups in the mean reduction in CRT from baseline to 12 months after the initial injection. Two eyes in the IVTA group required intraocular pressure-lowering medications.

CONCLUSION

Intravitreal injection of bevacizumab may be of greater benefit than that of TA for macular oedema because of BRVO.

摘要

目的

比较曲安奈德(TA)玻璃体腔内注射和贝伐单抗玻璃体腔内注射治疗视网膜分支静脉阻塞(BRVO)所致黄斑水肿的疗效。

设计

前瞻性、对比、随机、干预性临床试验。

方法

43 例 BRVO 所致黄斑水肿患者 43 只眼,随机分为 4mg 曲安奈德玻璃体腔内注射(IVTA)(21 例,IVTA 组)和 1.25mg 贝伐单抗玻璃体腔内注射(IVB)(22 例,IVB 组),随访 12 个月。初次注射后 3 个月内不给予其他治疗;初次注射后 3 至 12 个月内黄斑水肿复发时给予额外注射。在基线和每月测量最佳矫正视力(BCVA)和中心视网膜厚度(CRT)。主要观察指标为从基线到 12 个月时最小分辨角对数视力(BCVA)和 CRT 的变化。

结果

IVTA 组 18 例 18 只眼和 IVB 组 18 例 18 只眼完成 12 个月随访。IVTA 组从基线到 12 个月 BCVA 的平均改善为 0.12,IVB 组为 0.33,IVB 组显著高于 IVTA 组(p = 0.032)。初次注射后从基线到 12 个月 CRT 的平均降低两组间无显著差异。IVTA 组中有 2 只眼需要降眼压药物。

结论

与 TA 相比,贝伐单抗玻璃体腔内注射可能对 BRVO 所致黄斑水肿更有益。

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