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玻璃体内注射贝伐单抗治疗视网膜分支静脉阻塞引起的黄斑水肿的临床观察。

Intravitreal bevacizumab treatment for macular edema due to branch retinal vein occlusion in a clinical setting.

机构信息

Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.

出版信息

Curr Eye Res. 2012 Sep;37(9):823-9. doi: 10.3109/02713683.2012.678542. Epub 2012 Jun 5.

Abstract

PURPOSE

To report the functional and anatomical outcome of intravitreal bevacizumab (IVB) treatment for macular edema due to branch retinal vein occlusion (BRVO) in a clinical setting.

METHODS

The files of 45 patients treated with IVB for BRVO-induced macular edema at a tertiary medical center in 2007-2010 were reviewed. All received three loading doses (1.25 mg) and were followed every 6 weeks. Treatment was repeated for persistent or recurrent edema. If the edema did not resolve after 4-6 injections, grid laser photocoagulation was performed.

RESULTS

Mean patient age was 70.7 years (SD 8.5); mean follow-up time, 18.8 months (SD 8.3); mean number of injections, 8.8 (SD 3.8). Fourteen patients (33%) received grid laser treatment before bevacizumab and 23 (51%) after. Mean logMAR visual acuity (VA) was 0.63 (SD 0.43) before treatment (Snellen, 20/140) and 0.4 (SD 0.43) (Snellen, 20/70) after (p < 0.0005). Corresponding central macular thickness (CMT) values were 382.2 microns (SD 155.6) and 320.5 microns (SD 172.8) (p= 0.028). Positive correlations were found between initial VA and initial and final CMT (p = 0.004) and between gain in VA and reduction in CMT (p = 0.03). There was no statistically significant difference in mean initial or final VA and CMT between patients who received grid laser treatment before or during the study and those who did not.

CONCLUSIONS

IVB treatment improves visual function and reduces CMT in patients with BRVO-induced macular edema.

摘要

目的

报告在临床环境下,玻璃体内注射贝伐单抗(IVB)治疗视网膜分支静脉阻塞(BRVO)引起的黄斑水肿的功能和解剖结果。

方法

回顾了 2007 年至 2010 年在一家三级医疗中心接受 IVB 治疗 BRVO 引起的黄斑水肿的 45 名患者的病历。所有患者均接受了 3 次负荷剂量(1.25mg),并每 6 周进行一次随访。对于持续或复发的水肿,会重复治疗。如果 4-6 次注射后水肿仍未消退,则进行格栅激光光凝。

结果

患者平均年龄为 70.7 岁(标准差 8.5);平均随访时间为 18.8 个月(标准差 8.3);平均注射次数为 8.8 次(标准差 3.8)。在接受贝伐单抗治疗前,有 14 名患者(33%)接受了格栅激光治疗,在接受贝伐单抗治疗后,有 23 名患者(51%)接受了格栅激光治疗。治疗前平均对数视力(VA)为 0.63(标准差 0.43)(Snellen,20/140),治疗后为 0.4(标准差 0.43)(Snellen,20/70)(p<0.0005)。相应的中心黄斑厚度(CMT)值分别为 382.2μm(标准差 155.6)和 320.5μm(标准差 172.8)(p=0.028)。VA 的初始值与初始和最终 CMT 值之间呈正相关(p=0.004),VA 的增益与 CMT 的减少之间呈正相关(p=0.03)。在研究期间或之前接受格栅激光治疗与未接受格栅激光治疗的患者的平均初始或最终 VA 和 CMT 之间无统计学差异。

结论

玻璃体内注射贝伐单抗可改善 BRVO 引起的黄斑水肿患者的视力功能并减少 CMT。

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