Eye hospital of China academy of Chinese medical sciences, Shijingshan District, Beijing, 100040, China.
Graefes Arch Clin Exp Ophthalmol. 2012 Dec;250(12):1717-23. doi: 10.1007/s00417-012-2159-5. Epub 2012 Sep 25.
This systematic review assesses the prognostic factors for intravitreal bevacizumab injection (IVB) in the treatment of choroidal neovascularization (CNV) due to pathological myopia.
The literature searches were performed in Ovid Medline, EMBASE and CENTRAL. Relevant studies with prognostic data on best corrected vision acuity (BCVA) after intravitreal bevacizumab injection were included for review. Two reviewers participated in the data retrieval and independently assessed each included study.
A total 252 articles were retrieved, including 16 studies containing the most updated and complete data on prognostic factors for neovascularization due to pathological myopia treated by intravitreal bevacizumab injection. A great number of quantitative, clinical, and treatment-related factors were determined to have a positive influence on vision outcome after intravitreal bevacizumab.
A lower rate of development of chorioretinal atrophy, smaller pretreatment CNV size, and younger age were indentified as the most consistently significant prognostic factors affecting the efficacy of IVB in eyes of myopic CNV and were associated with improved BCVA. A worse BCVA after IVB in eyes with myopic CNV probably was associated with subfoveal CNV, lower baseline BCVA, longer duration of CNV, incomplete regression of CNV, subretinal hemorrhage, and previous PDT treatment. No apparent association were observed between the refraction error, axial length, lens status and change in BCVA after IVB. We indentified significant prognostic factors in this systematic review study that might allow for the selection of patients with myopic CNV which are most likely to benefit from IVB.
本系统评价评估了玻璃体内注射贝伐单抗(IVB)治疗病理性近视脉络膜新生血管(CNV)的预后因素。
在 Ovid Medline、EMBASE 和 CENTRAL 中进行文献检索。纳入了包含玻璃体内注射贝伐单抗后最佳矫正视力(BCVA)预后数据的相关研究进行综述。两名评审员参与了数据检索,并独立评估了每个纳入的研究。
共检索到 252 篇文章,包括 16 项研究,这些研究提供了关于玻璃体内注射贝伐单抗治疗病理性近视新生血管的最新和最完整的预后因素数据。大量定量、临床和治疗相关因素被确定对玻璃体内注射贝伐单抗后视力结果有积极影响。
脉络膜视网膜萎缩发生率较低、预处理 CNV 较小和年龄较小被确定为影响 IVB 疗效的最一致的重要预后因素,与 BCVA 改善相关。在病理性近视 CNV 眼中,IVB 后 BCVA 较差可能与中心凹下 CNV、较低的基线 BCVA、CNV 持续时间较长、CNV 不完全消退、视网膜下出血和先前 PDT 治疗有关。屈光不正、眼轴长度、晶状体状态和 IVB 后 BCVA 变化之间没有明显的相关性。我们在这项系统评价研究中确定了一些重要的预后因素,这些因素可能有助于选择最有可能从 IVB 中受益的病理性近视 CNV 患者。