G. B. Bietti Foundation for Ophthalmology, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy.
Retina. 2012 Sep;32(8):1539-46. doi: 10.1097/IAE.0b013e31826956b7.
To compare intravitreal bevacizumab (IVB) and intravitreal ranibizumab (IVR) in the treatment of subfoveal choroidal neovascularization associated with pathologic myopia.
Fifty-five patients fulfilling inclusion and exclusion criteria were randomized either to IVB or to IVR. After the first injection, re-treatments were performed on a pro re nata basis in monthly examinations over an 18-month follow-up. Primary outcome measures were the change in mean best-corrected visual acuity and the proportion of eyes improving in best-corrected visual acuity by >1 and >3 lines at the 18-month examination.
Forty-eight eyes received the treatment and were subsequently included in the analysis. At the 18-month examination, a significant improvement of 1.7 lines and 1.8 lines compared with baseline were noticed in the IVR and IVB subgroups, respectively. The difference in the final mean best-corrected visual acuity between the groups was not significant. A 3-line gain or higher was noted in 30% of eyes in the IVR subgroup and 44% of eyes in the IVB subgroup. Although both groups attained a significant improvement in central macular thickness, the IVR subgroup achieved a faster central macular thickness reduction. A significantly lower number of injections were administered in the IVR subgroup (2.5) compared with the IVB subgroup (4.7; P < 0.001).
Intravitreal ranibizumab and IVB are effective in the treatment of subfoveal myopic choroidal neovascularization. Intravitreal ranibizumab achieved greater efficacy than IVB in terms of the mean number of injections administered.
比较玻璃体内注射贝伐单抗(IVB)和玻璃体内注射雷珠单抗(IVR)治疗病理性近视性脉络膜新生血管(CNV)。
符合纳入和排除标准的 55 例患者随机分为 IVB 组或 IVR 组。首次注射后,在 18 个月的随访中每月进行一次复查,根据需要进行再治疗。主要观察指标为平均最佳矫正视力的变化,以及在 18 个月检查时最佳矫正视力提高>1 行和>3 行的眼比例。
48 只眼接受了治疗,随后被纳入分析。在 18 个月的检查中,IVR 和 IVB 亚组的平均最佳矫正视力分别较基线显著提高了 1.7 行和 1.8 行。两组最终平均最佳矫正视力的差异无统计学意义。IVR 亚组中有 30%的眼获得了 3 行或更高的提高,而 IVB 亚组中有 44%的眼获得了 3 行或更高的提高。虽然两组的中央黄斑厚度均显著改善,但 IVR 亚组的中央黄斑厚度减少更快。IVR 亚组的注射次数明显少于 IVB 亚组(2.5 次比 4.7 次;P<0.001)。
玻璃体内注射雷珠单抗和 IVB 对治疗黄斑下近视性脉络膜新生血管均有效。玻璃体内注射雷珠单抗在注射次数上的疗效优于 IVB。