Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Retina. 2012 Apr;32(4):687-95. doi: 10.1097/IAE.0b013e3182278bae.
To determine the 2-year results of intravitreal bevacizumab in highly myopic eyes with choroidal neovascularization (CNV).
An open-label, consecutive, interventional case series. Seventy-five eyes of 69 consecutive Japanese patients with either subfoveal or nonsubfoveal myopic CNVs were studied. The eyes were treated with intravitreal bevacizumab and followed-up for at least 2 years. The best-corrected visual acuities at the baseline in eyes with subfoveal CNV were compared with that in eyes with nonsubfoveal CNV at 2 years after the intravitreal bevacizumab.
The difference between the mean best-corrected visual acuity at the baseline and that at 2 years in eyes with a subfoveal CNV was not significant. However, the mean best-corrected visual acuity in eyes with nonsubfoveal CNV was significantly improved from 0.53 ± 0.36 logarithm of the minimal angle of resolution units (Snellen 20/66) before intravitreal bevacizumab to 0.29 ± 0.36 logMAR units (Snellen 20/40) (P < 0.001) 2 years after intravitreal bevacizumab. The incidence of chorioretinal atrophy after 2 years was 3 of 49 (6.1%) in eyes with nonsubfoveal CNV and 21 of 26 (80.8%) in eyes with which subfoveal CNV (P < 0.001). Furthermore, the chorioretinal atrophy area with nonsubfoveal CNV was 0.05 ± 0.21 mm, which was also significantly smaller than that of subfoveal CNV at 1.76 ± 1.60 mm (P < 0.001).
Intravitreal bevacizumab is a good treatment for eyes with nonsubfoveal CNV; however, another treatment is necessary for eyes with a subfoveally located CNV.
评估玻璃体内注射贝伐单抗治疗高度近视脉络膜新生血管(CNV)的 2 年疗效。
本研究为一项开放、连续、干预性病例系列研究。纳入 69 例(75 只眼)日本患者,所有患者均为单眼累及黄斑区的脉络膜新生血管(CNV),其中 38 只眼为中心凹下 CNV,37 只眼为中心凹外 CNV。所有患者均接受玻璃体内注射贝伐单抗治疗,随访至少 2 年。比较中心凹下和中心凹外 CNV 患眼治疗前和治疗后 2 年最佳矫正视力(BCVA)的变化。
中心凹下 CNV 患眼治疗前和治疗后 2 年 BCVA 的差异无统计学意义。而中心凹外 CNV 患眼治疗后 2 年 BCVA 明显提高,从治疗前的 0.53±0.36 对数最小分辨角视力(logMAR)(Snellen 视力 20/66)提高至治疗后的 0.29±0.36 logMAR (Snellen 视力 20/40)(P<0.001)。治疗后 2 年,中心凹外 CNV 患眼中有 3 只眼(6.1%)发生脉络膜视网膜萎缩,中心凹下 CNV 患眼中有 21 只眼(80.8%)发生脉络膜视网膜萎缩(P<0.001)。中心凹外 CNV 患眼的脉络膜视网膜萎缩面积为 0.05±0.21mm,明显小于中心凹下 CNV 患眼的 1.76±1.60mm(P<0.001)。
玻璃体内注射贝伐单抗治疗中心凹外 CNV 疗效确切,但对中心凹下 CNV 患者疗效不佳,需要其他治疗方法。