Department of Ophthalmology, Saint-Sacrement Hospital, Laval University, Québec, Canada.
Can J Ophthalmol. 2012 Apr;47(2):165-9. doi: 10.1016/j.jcjo.2012.01.011.
To compare the efficacy of intravitreal bevacizumab and ranibizumab for the treatment of neovascular age-related macular degeneration using an as-needed treatment regimen.
Retrospective chart review.
One hundred and ninety two eyes of 184 patients.
Patients received an initial treatment of 3 monthly intravitreal injections of ranibizumab or bevacizumab and retreatment is individually considered for each patient on the basis of optical coherence tomography, angiography, and clinical examination.
Fifty eyes treated with ranibizumab and 142 eyes treated with bevacizumab were included. The average age of the patients at baseline was 76.9 ± 8 years and 76.4 ± 8 years in the ranibizumab and bevacizumab group respectively. Mean visual acuity improved from 0.69 to 0.55 logMAR at 12 months in the ranibizumab group and from 0.70 to 0.67 logMAR in the bevacizumab group. At 12 months, 92% of eyes treated with ranibizumab had lost fewer than 0.3 logMAR, as compared with 83% in the bevacizumab group. The ranibizumab group received a mean of 4.92 injections, compared to 4.75 injections in the bevacizumab group over 12 months. After the first 3 injections, 20% of patients in the ranibizumab group and 26% in the bevacizumab group never needed another injection.
An approach based on clinical onset and choroidal neovascularization progression at angiography may provide benefit by reducing the number of intravitreal injections required.
比较按需治疗方案下玻璃体内注射贝伐单抗和雷珠单抗治疗新生血管性年龄相关性黄斑变性的疗效。
回顾性图表分析。
184 例患者的 192 只眼。
患者接受 3 个月的每月一次玻璃体内注射雷珠单抗或贝伐单抗初始治疗，然后根据光学相干断层扫描、血管造影和临床检查为每位患者单独考虑是否再次治疗。
50 只眼接受雷珠单抗治疗，142 只眼接受贝伐单抗治疗。患者的平均年龄在基线时分别为 76.9±8 岁和 76.4±8 岁。雷珠单抗组的平均视力从 0.69 提高到 12 个月时的 0.55 对数视力，贝伐单抗组从 0.70 提高到 0.67 对数视力。12 个月时，92%接受雷珠单抗治疗的眼视力损失少于 0.3 对数视力，而贝伐单抗组为 83%。雷珠单抗组平均注射 4.92 次，贝伐单抗组在 12 个月内平均注射 4.75 次。在前 3 次注射后，雷珠单抗组有 20%的患者和贝伐单抗组有 26%的患者从未需要再次注射。
基于临床发病和血管造影时脉络膜新生血管进展的治疗方法可能通过减少所需的玻璃体内注射次数提供益处。
