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比较单侧玻璃体内注射贝伐单抗和雷珠单抗对糖尿病患者对侧眼黄斑水肿的疗效。

Comparison of the effect of unilateral intravitreal bevacizumab and ranibizumab injection on diabetic macular edema of the fellow eye.

机构信息

Department of Ophthalmology, Faculty of Medicine, Selcuk University , Konya, Turkey .

出版信息

J Ocul Pharmacol Ther. 2013 Oct;29(8):728-32. doi: 10.1089/jop.2013.0049. Epub 2013 Jul 13.

Abstract

PURPOSE

To find out whether intravitreally administered bevacizumab and ranibizumab affect the contralateral, untreated, eyes of patients with bilateral diabetic macular edema (DME).

METHODS

A retrospective review of patients with bilateral DME, who were treated with intravitreal bevacizumab or ranibizumab, was performed. All enrolled patients received intravitreal 1.25 mg bevacizumab or 0.5 mg ranibizumab in the eye with more severe macular edema. As outcome measures, best-corrected visual acuity (BCVA) was assessed with the Early Treatment Diabetic Retinopathy Study chart and central foveal thickness (CFT) measurement was obtained using optical coherence tomography-3 before and at 2 and 4 weeks after injections.

RESULTS

The study included 55 eyes of 55 patients who received bevacizumab (group 1) and 32 eyes of 32 patients who received ranibizumab (group 2). The mean age of the 55 patients [35 female (63.6%), 20 male (36.4%)] in group 1 was 54.31±12.67 years, and the mean age of the 32 patients [20 female (62.5%), 12 male (37.5%)] in group 2 was 56.01±13.29 years. The median BCVA in the uninjected eye showed no statistically significant change at any visit after either bevacizumab or ranibizumab injection (P=0.302, P=0.582, respectively). In group 1, the median CFT in the uninjected eye was 417 μm at baseline; this was reduced to 401 μm at 2 weeks and 372 μm at 4 weeks. The change in CFT was found to be statistically significant (P=0.009). No statistically significant change was found in the median CFT of uninjected eyes of patients treated with ranibizumab (399, 403, and 407 μm before and at 2 and 4 weeks after treatment, respectively).

CONCLUSIONS

Compared with ranibizumab, intravitreal administration of bevacizumab resulted in a greater decrease in macular thickness in the untreated eye, in patients with bilateral DME.

摘要

目的

探讨玻璃体内注射贝伐单抗和雷珠单抗是否会影响双侧糖尿病黄斑水肿(DME)患者对侧未治疗眼的情况。

方法

对接受玻璃体内贝伐单抗或雷珠单抗治疗的双侧 DME 患者进行回顾性分析。所有入组患者均在黄斑水肿较重的眼中接受玻璃体内 1.25mg 贝伐单抗或 0.5mg 雷珠单抗注射。以最佳矫正视力(BCVA)和中心凹视网膜厚度(CFT)为观察指标,采用 ETDRS 图表评估 BCVA,采用光学相干断层扫描-3 测量注射前及注射后 2 周和 4 周的 CFT。

结果

该研究共纳入 55 只眼(55 例患者)接受贝伐单抗治疗(第 1 组)和 32 只眼(32 例患者)接受雷珠单抗治疗(第 2 组)。第 1 组 55 例患者(35 例女性[63.6%],20 例男性[36.4%])的平均年龄为 54.31±12.67 岁,第 2 组 32 例患者(20 例女性[62.5%],12 例男性[37.5%])的平均年龄为 56.01±13.29 岁。玻璃体内注射贝伐单抗或雷珠单抗后,未治疗眼的平均 BCVA 在任何时间点均无统计学意义的变化(分别为 P=0.302、P=0.582)。第 1 组未治疗眼的 CFT 基线值为 417μm,注射后 2 周降为 401μm,4 周降为 372μm,CFT 变化有统计学意义(P=0.009)。接受雷珠单抗治疗的患者未治疗眼的 CFT 中位数无统计学意义的变化(分别为治疗前及治疗后 2 周和 4 周的 399、403 和 407μm)。

结论

与雷珠单抗相比,玻璃体内注射贝伐单抗可使双侧 DME 患者未治疗眼中的黄斑厚度明显降低。

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