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玻璃体内注射贝伐单抗单药治疗1型阈值前期、阈值期及侵袭性早产儿视网膜病变——来自土耳其的27个月随访结果

Intravitreal bevacizumab monotherapy for type-1 prethreshold, threshold, and aggressive posterior retinopathy of prematurity - 27 month follow-up results from Turkey.

作者信息

Yetik Huseyin, Gunay Murat, Sirop Sarkis, Salihoglu Ziya

机构信息

Cerrahpasa School of Medicine, Istanbul University, Fatih, Istanbul, Turkey.

Surp Pirgic Armenian Foundation Hospital, Affiliated Hospital of Istanbul University, Zakirbaşı Sokak, 34020, Zeytinburnu, Istanbul, Turkey.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2015 Oct;253(10):1677-83. doi: 10.1007/s00417-014-2867-0. Epub 2014 Dec 14.

DOI:10.1007/s00417-014-2867-0
PMID:25501298
Abstract

PURPOSE

To study the efficacy of intravitreal bevacizumab (IVB) injection as a single treatment for retinopathy of prematurity (ROP).

METHODS

This was a prospective interventional case series study performed in a clinical practice setting; a total of 122 patients including prethreshold (type 1) (n  = 79, 152 eyes, six unilateral), threshold (n = 12, 24 eyes), and aggressive posterior (APROP) (n = 31, 62 eyes); cases were included without any randomization or masking. A total of 253 IVB injections, 238 in the first session, 11 in the second session, and four in the third session were performed, and followed up for a mean of 89.155 ± 4.277 (range 82 to 105) weeks of postmenstrual age (PMA). Regression of ROP, maturation of the retina, and associated complications were evaluated.

RESULTS

Total regression was achieved in 227/238 eyes (95.4 %) after the first dose injection. The remaining 11 received a second injection, after which an additional seven (234/238; 98.2 %) regressed; after the third injection, the remaining 4 (238/238; 100 %) regressed. Complete retinal vascular maturation was achieved without any significant complications in all of the cases.

CONCLUSIONS

IVB injection as monotherapy seems to be a very effective treatment modality for ROP. Based on timely intervention, IVB as a single treatment modality can salvage almost all ROP cases before stage 4.

摘要

目的

研究玻璃体内注射贝伐单抗(IVB)单一治疗早产儿视网膜病变(ROP)的疗效。

方法

这是一项在临床实践环境中进行的前瞻性干预性病例系列研究;共纳入122例患者,包括阈值前期(1型)(n = 79,152只眼,6例单眼)、阈值期(n = 12,24只眼)和侵袭性后部ROP(APROP)(n = 31,62只眼);病例纳入未进行任何随机分组或设盲。共进行了253次IVB注射,第一次注射238次,第二次注射11次,第三次注射4次,并随访至平均月经后年龄(PMA)89.155±4.277周(范围82至105周)。评估ROP的消退、视网膜成熟度及相关并发症。

结果

首次注射后,227/238只眼(95.4%)完全消退。其余11只眼接受了第二次注射,之后又有7只眼(234/238;98.2%)消退;第三次注射后,其余4只眼(238/238;100%)消退。所有病例均实现了完全的视网膜血管成熟,且无任何严重并发症。

结论

IVB注射作为单一疗法似乎是治疗ROP的一种非常有效的治疗方式。基于及时干预,IVB作为单一治疗方式可挽救几乎所有4期以前的ROP病例。

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