英国真实临床实践中贝伐单抗治疗视网膜中央静脉阻塞和视网膜分支静脉阻塞所致慢性黄斑水肿的一年疗效
One-year outcome of bevacizumab therapy for chronic macular edema in central and branch retinal vein occlusions in real-world clinical practice in the UK.
作者信息
Lip Peck Lin, Malick Huzaifa, Damer Kenan, Elsherbiny Samer, Darrad Kanupriya M, Mushtaq Bushra, Mitra Arijit, Stavrou Panagiota, Yang Yit
机构信息
Birmingham and Midland Eye Centre, City Hospital, Aston University, Birmingham, UK.
Birmingham and Midland Eye Centre, City Hospital, Aston University, Birmingham, UK ; School of Health and Life Sciences, Aston University, Birmingham, UK.
出版信息
Clin Ophthalmol. 2015 Sep 25;9:1779-84. doi: 10.2147/OPTH.S89147. eCollection 2015.
BACKGROUND
The purpose of this study was to investigate the 12-month outcome of macular edema secondary to both chronic and new central and branch retinal vein occlusions treated with intravitreal bevacizumab in the real-life clinical setting in the UK.
METHODS
Retrospective case notes analysis of consecutive patients with retinal vein occlusions treated with bevacizumab in 2010 to 2012. Outcome measures were visual acuity (measured with Snellen, converted into logMAR [logarithm of the minimum angle of resolution] for statistical calculation) and central retinal thickness at baseline, 4 weeks post-loading phase, and at 1 year.
RESULTS
There were 56 and 100 patients with central and branch retinal vein occlusions, respectively, of whom 62% had chronic edema and received prior therapies and another 32% required additional laser treatments post-baseline bevacizumab. Baseline median visual acuity was 0.78 (interquartile range [IQR] 0.48-1.22) in the central group and 0.6 (IQR 0.3-0.78) in the branch group. In both groups, visual improvement was statistically significant from baseline compared to post-loading (P<0.001 and P=0.03, respectively), but was not significant by month 12 (P=0.058 and P=0.166, respectively); 30% improved by at least three lines and 44% improved by at least one line by month 12. Baseline median central retinal thickness was 449 μm (IQR 388-553) in the central group and 441 μm (IQR 357-501) in the branch group. However, the mean reduction in thickness was statistically significant at post-loading (P<0.001) and at the 12-month time point (P<0.001) for both groups. The average number of injections in 1 year was 4.2 in the central group and 3.3 in the branch group.
CONCLUSION
Our large real-world cohort results indicate that bevacizumab introduced to patients with either new or chronic edema due to retinal vein occlusion can result in resolution of edema and stabilization of vision in the first year.
背景
本研究旨在调查在英国现实临床环境中，玻璃体内注射贝伐单抗治疗继发于慢性及新发的视网膜中央静脉阻塞和视网膜分支静脉阻塞的黄斑水肿的12个月结局。
方法
对2010年至2012年接受贝伐单抗治疗的视网膜静脉阻塞连续患者进行回顾性病例记录分析。结局指标为基线、负荷期后4周及1年时的视力（用Snellen视力表测量，为进行统计计算转换为logMAR [最小分辨角对数]）和视网膜中央厚度。
结果
分别有56例和100例视网膜中央静脉阻塞和视网膜分支静脉阻塞患者，其中62%有慢性水肿且接受过先前治疗，另外32%在基线贝伐单抗治疗后需要额外的激光治疗。中央组基线中位视力为0.78（四分位间距[IQR] 0.48 - 1.22），分支组为0.6（IQR 0.3 - 0.78）。两组中，与负荷期后相比，从基线开始视力改善均有统计学意义（分别为P<0.001和P = 0.03），但在12个月时无统计学意义（分别为P = 0.058和P = 0.166）；到12个月时，30%至少提高了3行，44%至少提高了1行。中央组基线中位视网膜中央厚度为449μm（IQR 388 - 553），分支组为441μm（IQR 357 - 501）。然而，两组在负荷期后（P<0.001）和12个月时间点（P<0.001）厚度的平均降低均有统计学意义。中央组1年的平均注射次数为4.2次，分支组为3.3次。
结论
我们的大型真实世界队列研究结果表明，对于因视网膜静脉阻塞导致新发或慢性水肿的患者，注射贝伐单抗可在第一年使水肿消退并稳定视力。
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