Liang I-Chia, Chang Yu-Ying, Lee Tong-Sheng, Lin Yi-Ru, Liu Kwan-Rong
Cathay General Hospital, Taipei City, Taiwan, ROC.
Int Ophthalmol. 2014 Aug;34(4):971-7. doi: 10.1007/s10792-014-9907-y. Epub 2014 Feb 2.
The aim of this study was to report the successful treatment of choroidal neovascularization (CNV) in pathologic myopia (PM) with a posterior sub-Tenon bevacizumab (PSTB; Avastin(®)) injection. The study was a prospective case series including nine eyes of eight patients with PM and CNV. All nine eyes were injected with PSTB (12.5 mg/0.5 ml). Treatment effectiveness was evaluated with optical coherence tomography (OCT). If intraretinal edema or subretinal fluid were detected, injections were repeated after 2 weeks. The main outcome measures were logMAR best-corrected visual acuity (BCVA) and central foveal thickness. The mean follow-up time was 77.56 weeks. BCVA improved by a mean of -0.38 logMAR (>3 lines). The average reduction in absolute central foveal thickness was 25.67 μm. OCT revealed marked CNV volume reduction and fluid-free status in seven eyes. The fluid-free status remained for ≥ 1 year in these eyes. Fluorescein angiography revealed CNV resolution in three eyes. Corneal stromal penetration of subconjunctival bevacizumab has been demonstrated in animal studies. PSTB may be an equally effective, yet less invasive alternative for the treatment of myopic CNV.
本研究的目的是报告通过后Tenon囊下注射贝伐单抗（PSTB；阿瓦斯汀®）成功治疗病理性近视（PM）合并脉络膜新生血管（CNV）的情况。该研究是一项前瞻性病例系列研究，纳入了8例患有PM和CNV的患者的9只眼。所有9只眼均接受了PSTB注射（12.5 mg/0.5 ml）。采用光学相干断层扫描（OCT）评估治疗效果。如果检测到视网膜内水肿或视网膜下液，则在2周后重复注射。主要观察指标为最小分辨角对数（logMAR）最佳矫正视力（BCVA）和中心凹厚度。平均随访时间为77.56周。BCVA平均提高了-0.38 logMAR（>3行）。中心凹绝对厚度平均减少了25.67μm。OCT显示7只眼中CNV体积明显减小且无液。这些眼中无液状态持续≥1年。荧光素血管造影显示3只眼中CNV消退。动物研究已证实结膜下贝伐单抗可穿透角膜基质。PSTB可能是治疗近视性CNV的一种同样有效但侵入性较小的替代方法。
