贝伐单抗联合靶向光凝与单纯贝伐单抗治疗缺血性视网膜分支静脉阻塞所致黄斑水肿的对比研究

Comparative study of combined bevacizumab/targeted photocoagulation vs bevacizumab alone for macular oedema in ischaemic branch retinal vein occlusions.

作者信息

Tomomatsu Yoko, Tomomatsu Takeshi, Takamura Yoshihiro, Gozawa Makoto, Arimura Shogo, Takihara Yuji, Inatani Masaru

机构信息

Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Yoshida-Gun, Fukui-Ken, Japan.

出版信息

Acta Ophthalmol. 2016 May;94(3):e225-30. doi: 10.1111/aos.12721. Epub 2015 May 19.

DOI:10.1111/aos.12721

PMID:25989706

Abstract

PURPOSE

To investigate whether targeted retinal photocoagulation (TRP) of peripheral non-perfused areas (NPAs) could prevent the recurrence of macular oedema (ME) due to branch retinal vein occlusion (BRVO) after intravitreal bevacizumab injection (IVB).

METHODS

Eyes received 1.25 mg IVB only (IVB group) or combined with TRP (IVB + TRP group) of NPAs, more than 5 disc areas identified by fluorescein angiography in the patients with ME secondary to BRVO. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) determined by optical coherence tomography were measured every month for 6 months.

RESULTS

Thirty-eight patients were enrolled and randomized to IVB group (n = 19) and IVB + TRP group (n = 19). Both groups showed similar thinning in CRT at 1 week after IVB, IVB + TRP group maintained thinner retina at 2 (p = 0.0072) and 3 (p = 0.0086) months compared with IVB group in whom turned to thickened almost back to baseline at 3 months. The number of reinjections in IVB group (1.58 ± 0.69) was significantly greater (p = 0.0025) than that in IVB + TRP group (0.83 ± 0.62). BCVA significantly improved at 6 month in IVB + TRP group (p = 0.015), but not in IVB group.

CONCLUSION

TRP of NPAs reduced the amount of ME recurrence following IVB compared to IVB alone.

摘要

目的

研究对周边无灌注区（NPA）进行靶向视网膜光凝（TRP）是否能预防玻璃体内注射贝伐单抗（IVB）后视网膜分支静脉阻塞（BRVO）所致黄斑水肿（ME）的复发。

方法

对于继发于BRVO的ME患者，通过荧光素血管造影确定超过5个视盘面积的NPA，仅接受1.25mg IVB治疗的眼（IVB组）或联合TRP治疗的眼（IVB + TRP组）。连续6个月每月测量最佳矫正视力（BCVA）和光学相干断层扫描测定的中心视网膜厚度（CRT）。

结果

38例患者入组并随机分为IVB组（n = 19）和IVB + TRP组（n = 19）。IVB后1周两组CRT均有相似程度变薄，与IVB组相比，IVB + TRP组在2个月（p = 0.0072）和3个月（p = 0.0086）时视网膜维持较薄状态，而IVB组在3个月时几乎增厚回到基线水平。IVB组再次注射的次数（1.58±0.69）显著多于IVB + TRP组（0.83±0.62）（p = 0.0025）。IVB + TRP组在6个月时BCVA显著改善（p = 0.015），而IVB组未改善。