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日本病理性近视脉络膜新生血管患者玻璃体内注射贝伐单抗的两年疗效。

Two-year outcomes of intravitreal bevacizumab for choroidal neovascularization in Japanese patients with pathologic myopia.

机构信息

Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Retina. 2012 Apr;32(4):687-95. doi: 10.1097/IAE.0b013e3182278bae.

Abstract

PURPOSE

To determine the 2-year results of intravitreal bevacizumab in highly myopic eyes with choroidal neovascularization (CNV).

METHODS

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.

RESULTS

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).

CONCLUSION

Intravitreal bevacizumab is a good treatment for eyes with nonsubfoveal CNV; however, another treatment is necessary for eyes with a subfoveally located CNV.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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