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系列玻璃体内注射贝伐单抗治疗复发性增生性玻璃体视网膜病变视网膜脱离的疗效

Effect of Serial Intrasilicone Oil Bevacizumab Injections in Eyes With Recurrent Proliferative Vitreoretinopathy Retinal Detachment.

作者信息

Hsu Jason, Khan M Ali, Shieh Wen-Shi, Chiang Allen, Maguire Joseph I, Park Carl H, Garg Sunir J, Ho Allen C, Kaiser Richard S

机构信息

The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.

The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania.

出版信息

Am J Ophthalmol. 2016 Jan;161:65-70.e1-2. doi: 10.1016/j.ajo.2015.09.029. Epub 2015 Oct 21.

Abstract

PURPOSE

To investigate the effect of serial intrasilicone oil bevacizumab injections (1.25 mg/0.05 mL) on visual acuity (VA) and anatomic outcomes in eyes undergoing proliferative vitreoretinopathy (PVR)-related retinal detachment (RD) repair.

DESIGN

Prospective, nonrandomized, historical-control pilot study.

METHODS

setting: Tertiary care center.

STUDY POPULATION

Nondiabetic eyes undergoing pars plana vitrectomy (PPV) and silicone oil tamponade with or without scleral buckling procedure (SBP) for recurrent RD due to PVR.

INTERVENTION

Intrasilicone oil injection of 1.25 mg bevacizumab was performed intraoperatively and at postoperative months 1, 2, and 3.

OUTCOMES

Retinal reattachment rate, final VA, and rate of epiretinal membrane (ERM) formation at month 6.

RESULTS

Twenty eyes of 20 patients were enrolled and compared to a historical control group composed of 35 age- and sex-matched controls. In the study group, logMAR VA improved from mean 1.78 ± 0.43 (Snellen 20/1205) to 1.43 ± 0.70 (Snellen 20/538, P = .04), retinal reattachment was achieved in 14 of 20 eyes (70%), and ERM formation was observed in 7 of 20 eyes (35%) at 6 months. In the control group, logMAR VA improved from mean 1.50 ± 0.74 (Snellen 20/632) to 1.43 ± 0.58 (Snellen 20/538, P = .64), retinal reattachment was achieved in 25 of 35 eyes (71%), and ERM formation was observed in 7 of 35 eyes (20%) at 6 months. No significant difference in final VA (P = .96), retinal reattachment rate (P = .75), or ERM formation (P = .33) was observed between groups. No intrasilicone oil injection-related adverse events occurred.

CONCLUSIONS

Serial intrasilicone oil injections of bevacizumab did not improve retinal reattachment rate, improve final VA, or reduce ERM formation in patients undergoing PVR-related RD surgery.

摘要

目的

探讨系列玻璃体内注射贝伐单抗(1.25mg/0.05mL)对增生性玻璃体视网膜病变(PVR)相关视网膜脱离(RD)修复术后患眼视力(VA)及解剖学转归的影响。

设计

前瞻性、非随机、历史对照试验性研究。

方法

地点:三级医疗中心。

研究对象

因PVR导致复发性RD而接受玻璃体切除术(PPV)及硅油填充、伴或不伴巩膜扣带术(SBP)的非糖尿病患眼。

干预措施

术中及术后1、2、3个月行玻璃体内注射1.25mg贝伐单抗。

观察指标

视网膜复位率、最终视力及术后6个月视网膜前膜(ERM)形成率。

结果

纳入20例患者的20只眼,并与由35例年龄及性别匹配的对照者组成的历史对照组进行比较。研究组中,logMAR视力从平均1.78±0.43(Snellen 20/1205)提高至1.43±0.70(Snellen 20/538,P = 0.04);20只眼中14只(70%)实现视网膜复位;术后6个月,20只眼中7只(35%)观察到ERM形成。对照组中,logMAR视力从平均1.50±0.74(Snellen 20/632)提高至1.43±0.58(Snellen 20/538,P = 0.64);35只眼中25只(71%)实现视网膜复位;术后6个月,35只眼中7只(20%)观察到ERM形成。两组间最终视力(P = 0.96)、视网膜复位率(P = 0.75)或ERM形成(P = 0.33)均未观察到显著差异。未发生与玻璃体内注射相关的不良事件。

结论

对于接受PVR相关RD手术的患者,系列玻璃体内注射贝伐单抗未提高视网膜复位率、改善最终视力或减少ERM形成。

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