Kianersi Farzan, Naderi Beni Afsaneh, Naderi Beni Zahra, Ghanbari Heshmatollah
Isfahan University of Medical Sciences , Isfahan , Iran and.
Semin Ophthalmol. 2015 May;30(3):181-7. doi: 10.3109/08820538.2013.838278. Epub 2013 Oct 31.
To evaluate the efficacy and safety of intravitreal bevacizumab (Avastin) in treatment of choroidal neovascularization (CNV) secondary to toxoplasmic retinochoroiditis.
Prospective case series.
Four patients affected by CNV secondary to inactive toxoplasmic retinochoroiditis received 1.25 mg intravitreal bevacizumab and were followed for at least six months. Patients underwent a full ophthalmic examination and fluorescein angiography (FA) and optical coherence tomography (OCT), revealing an active subfoveal CNV close to an old chorioretinal scar. All the patients were positive for toxoplasma immunoglobulins. Outcome measures were changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) and any adverse event related to the therapy.
CNV regressed at eight weeks of follow-up and remained stable at six months of follow-up. Best-corrected visual acuity improved from mean 0.05 to 0.25. After six months, the BCVA improved in all patients (p < 0.05) and CMT decreased from 396 +/-7 micron to 253+/-17 micron. Metamorphopsia was resolved in all cases.
Intravitreal bevacizumab seems to be an effective treatment for the long-term control of juxta/subfoveal CNV secondary to toxoplasmic retinochoroiditis. Further trials are mandatory to validate the data of our case series.
评估玻璃体内注射贝伐单抗(阿瓦斯汀)治疗弓形虫性视网膜脉络膜炎继发脉络膜新生血管(CNV)的疗效和安全性。
前瞻性病例系列研究。
4例弓形虫性视网膜脉络膜炎静止期继发CNV的患者接受了1.25mg玻璃体内贝伐单抗注射,并随访至少6个月。患者接受了全面的眼科检查、荧光素血管造影(FA)和光学相干断层扫描(OCT),结果显示在陈旧性脉络膜视网膜瘢痕附近有活动性黄斑下CNV。所有患者弓形虫免疫球蛋白均呈阳性。观察指标为最佳矫正视力(BCVA)、中心黄斑厚度(CMT)的变化以及与治疗相关的任何不良事件。
随访8周时CNV消退,随访6个月时保持稳定。最佳矫正视力从平均0.05提高到0.25。6个月后,所有患者的BCVA均有改善(p<0.05),CMT从396±7微米降至253±17微米。所有病例的视物变形均得到缓解。
玻璃体内注射贝伐单抗似乎是长期控制弓形虫性视网膜脉络膜炎继发黄斑旁/黄斑下CNV的有效治疗方法。需要进一步的试验来验证我们病例系列的数据。