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玻璃体内抗血管内皮生长因子疗法治疗视网膜大动脉瘤

Intravitreal anti-VEGF therapy for retinal macroaneurysm.

作者信息

Zweifel S A, Tönz M S, Pfenninger L, Becker M, Michels S

机构信息

University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland.

出版信息

Klin Monbl Augenheilkd. 2013 Apr;230(4):392-5. doi: 10.1055/s-0032-1328377. Epub 2013 Apr 29.

Abstract

BACKGROUND

We evaluated the effect of intravitreal anti-vascular endothelial growth factor therapy using bevacizumab or ranibizumab for retinal macroaneurysms with macular exudation.

METHODS

In a retrospective interventional case series patients with retinal macroaneurysms were treated with either 1.25 mg intravitreal bevacizumab or 0.5 mg ranibizumab as first-line therapy. Patients were imaged by fluorescein angiography and optical coherence tomography. Retreatment was performed in case of persistent intraretinal or subretinal fluid in optical coherence tomography.

RESULTS

Ten patients (10 eyes) with macroaneurysm involving the macula were treated with an average of 3.0 intravitreal anti-vascular endothelial growth factor injections. Mean best corrected visual acuity of all patients improved by 17 letters from baseline to the last follow-up visit. In 7 out of 10 patients, the fovea was affected by a secondary edema. In cases with foveal involvement, central retinal thickness decreased from 366 µm at baseline to 266 µm at the last follow-up visit. In the course of treatment 8 out of 10 patients showed evidence of marked regression of macular exsudation.

CONCLUSION

Intravitreal anti-vascular endothelial growth factor therapy appears to be a promising treatment alternative to laser treatment in cases of retinal macroaneurysms with macular exudation.

摘要

背景

我们评估了玻璃体内注射贝伐单抗或雷珠单抗抗血管内皮生长因子疗法对伴有黄斑渗出的视网膜大动脉瘤的疗效。

方法

在一项回顾性介入病例系列研究中,视网膜大动脉瘤患者接受1.25mg玻璃体内贝伐单抗或0.5mg雷珠单抗作为一线治疗。患者通过荧光素血管造影和光学相干断层扫描进行成像。光学相干断层扫描显示视网膜内或视网膜下液持续存在时进行再次治疗。

结果

10例(10只眼)累及黄斑的大动脉瘤患者平均接受了3.0次玻璃体内抗血管内皮生长因子注射。所有患者的平均最佳矫正视力从基线到最后一次随访提高了17个字母。10例患者中有7例黄斑中心凹受到继发性水肿影响。黄斑中心凹受累的病例中,视网膜中央厚度从基线时的366μm降至最后一次随访时的266μm。在治疗过程中,10例患者中有8例显示黄斑渗出明显消退。

结论

对于伴有黄斑渗出的视网膜大动脉瘤病例,玻璃体内抗血管内皮生长因子疗法似乎是一种有前景的替代激光治疗的方法。

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