San Giuseppe Hospital, University Eye Clinic, Milan, Italy.
Am J Ophthalmol. 2013 Feb;155(2):287-294.e1. doi: 10.1016/j.ajo.2012.07.029. Epub 2012 Oct 27.
To evaluate the anatomic and functional results of the treatment with intravitreal bevacizumab in complicated retinal arterial macroaneurysm (RAM).
A multicenter interventional, prospective, nonrandomized study.
Thirty-eight macroaneurysms of 37 patients with foveal complications were evaluated. All patients underwent a comprehensive ophthalmologic examination, fluorescein angiography (FA), and spectral-domain optical coherence tomography (SD OCT) examination. Each patient underwent 3 monthly injections of bevacizumab 1.25 mg/0.05 mL; 3 follow-up visits were planned at week 2, 6, and 12.
Both best-corrected visual acuity (BCVA), expressed in logarithm of minimal angle of resolution (logMAR), and central retinal thickness (CRT) significantly improved during the follow-up visits (0.57 ± 0.21 vs 0.41 ± 0.15 vs 0.23 ± 0.13 vs 0.09 ± 0.10 and 520.38 ± 191.05 vs 396.24 ± 136.18 vs 283.86 ± 71.87 vs 214.84 ± 26.86, respectively, Friedman test P < .0001 for all variables). At 6 weeks of follow-up, FA showed complete closure of the RAM in 36 of 38 cases (94.7%). Four weeks following the third injection, the macular edema had completely resolved and hard exudates regressed slowly in 100% of patients.
Intravitreal bevacizumab is an effective therapy for complicated RAM, quickly improving BCVA and CRT. Anti-vascular endothelial growth factor (VEGF) drugs might actively close the involved pathologically permeabilized retinal artery and normalize the vessel wall formation by localized inhibition of VEGF.
评估玻璃体内注射贝伐单抗治疗复杂视网膜动脉大动脉瘤（RAM）的解剖和功能结果。
多中心干预性、前瞻性、非随机研究。
评估了 37 例伴有黄斑并发症的患者的 38 个大动脉瘤。所有患者均接受全面眼科检查、荧光素血管造影（FA）和谱域光相干断层扫描（SD OCT）检查。每位患者接受了 3 次贝伐单抗 1.25mg/0.05mL 的每月注射治疗；计划进行 3 次随访，分别在第 2、6 和 12 周进行。
在随访期间，最佳矫正视力（BCVA）和中央视网膜厚度（CRT）均显著改善，以最小分辨角对数（logMAR）表示（0.57±0.21 对 0.41±0.15 对 0.23±0.13 对 0.09±0.10 和 520.38±191.05 对 396.24±136.18 对 283.86±71.87 对 214.84±26.86，Friedman 检验 P<0.0001）。在第 6 周的 FA 检查中，38 例中的 36 例（94.7%）完全闭合了 RAM。在第三次注射后的第 4 周，所有患者的黄斑水肿完全消退，硬性渗出物缓慢消退。
玻璃体内注射贝伐单抗是治疗复杂 RAM 的有效方法，可快速改善 BCVA 和 CRT。抗血管内皮生长因子（VEGF）药物可能通过局部抑制 VEGF 积极关闭受影响的病理性通透性视网膜动脉并使血管壁形成正常化。
