Arevalo J Fernando, Lasave Andres F, Wu Lihteh, Acón Dhariana, Berrocal María H, Diaz-Llopis Manuel, Gallego-Pinazo Roberto, Serrano Martin A, Alezzandrini Arturo A, Rojas Sergio, Maia Mauricio, Lujan Silvio
*Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD; †The Vitreoretinal and Uveitis Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia; ‡The Retina and Vitreous Service, Clínica Privada de Ojos, Mar del Plata, Argentina; § Instituto de Cirugia Ocular, San Jose, Costa Rica; ¶University of Puerto Rico, San Juan, Puerto Rico; **Hospital La Fe, Universidad de Valencia, Spain; ††Clinica Oftalmologica Centro Caracas and the Arevalo-Coutinho Foundation for Research in Ophthalmology, Caracas, Venezuela; ‡‡OFTALMOS, Universidad de Buenos Aires, Facultad de Medicina, Buenos Aires, Argentina; §§Fundación Hospital Nuestra Señora de la Luz, Mexico City, Mexico; ¶¶Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil; and ***MACULA D&T Diagnóstico, Tratamiento & Rehabilitación Visual, Lima, Peru.
Retina. 2016 May;36(5):859-67. doi: 10.1097/IAE.0000000000000827.
To report the long-term anatomical and functional outcomes of patients with choroidal neovascularization secondary to age-related macular degeneration treated with intravitreal bevacizumab (IVB).
Retrospective case series. Patients diagnosed with subfoveal choroidal neovascularization secondary to age-related macular degeneration that were treated with at least 1 intravitreal injection of 1.25 mg of IVB and had a minimum follow-up of 60 months. Patients underwent best-corrected Snellen visual acuity testing, optical coherence tomography, and ophthalmoscopic examination at baseline and follow-up visits.
Two hundred and forty-seven consecutive patients (292 eyes) were included. The mean number of IVB injections per eye was 10.9 ± 6.4. At 5 years, the BCVA decreased from 20/150 (logMAR 0.9 ± 0.6) at baseline to 20/250 (logMAR 1.1 ± 0.7) (P = <0.0001). The mean CMT decreased from 343.1+ 122.3 μm at baseline to 314.7 ± 128.8 μm at 60 months of follow-up (P = 0.009). Geographic atrophy (GA) was observed at baseline in 47 (16%) of 292 eyes. By 5 years, GA developed or progressed in 124 (42.5%) of 292 eyes (P < 0.0001).
The early visual gains obtained from IVB were not maintained at 5 years of follow-up. In addition, IVB may play a role in the development or progression of GA.
报告玻璃体内注射贝伐单抗（IVB）治疗年龄相关性黄斑变性继发脉络膜新生血管患者的长期解剖学和功能结果。
回顾性病例系列研究。诊断为年龄相关性黄斑变性继发黄斑下脉络膜新生血管且接受至少1次1.25mg玻璃体内注射IVB治疗且随访至少60个月的患者。患者在基线和随访时接受最佳矫正视力测试、光学相干断层扫描和检眼镜检查。
纳入247例连续患者（292只眼）。每只眼IVB注射的平均次数为10.9±6.4次。5年时，最佳矫正视力从基线时的20/150（logMAR 0.9±0.6）降至20/250（logMAR 1.1±0.7）（P =<0.0001）。平均中心凹视网膜厚度从基线时的343.1+122.3μm降至随访60个月时的314.7±128.8μm（P = 0.009）。在292只眼中，47只（16%）在基线时观察到地图样萎缩（GA）。到5年时，292只眼中有124只（42.5%）发生GA或GA进展（P < 0.0001）。
IVB治疗早期获得的视力改善在随访5年时未得到维持。此外，IVB可能在GA的发生或进展中起作用。
