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增生性糖尿病视网膜病变患者行玻璃体切割术,术前单次玻璃体腔内注射或未注射贝伐单抗后的6个月视力转归

Six-month visual outcome after pars plana vitrectomy in proliferative diabetic retinopathy with or without a single preoperative injection of intravitreal bevacizumab.

作者信息

Gupta Amod, Bansal Reema, Gupta Vishali, Dogra Mangat R

机构信息

Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.

出版信息

Int Ophthalmol. 2012 Apr;32(2):135-44. doi: 10.1007/s10792-012-9541-5. Epub 2012 Mar 27.

Abstract

The purpose of this study is to evaluate the effect of a single preoperative injection of intravitreal bevacizumab (IVB) on visual outcome in patients undergoing pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). Retrospective chart review of patients who underwent PPV for PDR and followed for at least 6 months after surgery. Patients who received a single IVB injection (1.25 mg in 0.05 ml) preoperatively were assigned to group A. Those who did not receive IVB were assigned to group B. The primary outcome measure was visual outcome at 6-month follow-up. The secondary outcomes were postoperative complications. At 6 months, visual acuity improved by at least 0.3 logMAR units in 70 (74.5 %) of the 94 eyes in group A versus 46 (52.9 %) of the 87 eyes in group B (p = 0.002). Postoperative vitreous hemorrhage occurred significantly less frequently in group A (6 eyes, 6.4 %) than in group B (14 eyes, 16.1 %; p = 0.037). The incidence of other postoperative complications did not differ significantly between the two groups. Preoperative use of bevacizumab improved the 6-month visual outcome in patients undergoing PPV for PDR and significantly reduced the occurrence of postoperative vitreous hemorrhage.

摘要

本研究的目的是评估术前单次玻璃体内注射贝伐单抗(IVB)对接受玻璃体视网膜手术(PPV)治疗增殖性糖尿病视网膜病变(PDR)患者视力预后的影响。对接受PPV治疗PDR且术后随访至少6个月的患者进行回顾性病历审查。术前接受单次IVB注射(0.05 ml中含1.25 mg)的患者被分配到A组。未接受IVB的患者被分配到B组。主要结局指标是6个月随访时的视力预后。次要结局是术后并发症。6个月时,A组94眼中有70眼(74.5%)的视力至少提高了0.3 logMAR单位,而B组87眼中有46眼(52.9%)(p = 0.002)。A组术后玻璃体积血的发生率(6眼,6.4%)明显低于B组(14眼,16.1%;p = 0.037)。两组间其他术后并发症的发生率无显著差异。术前使用贝伐单抗改善了接受PPV治疗PDR患者的6个月视力预后,并显著降低了术后玻璃体积血的发生率。

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