Fischer C, Schäfer K, Dschietzig T, Hoerauf H
Klinik für Augenheilkunde, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
Immundiagnostik AG, Bensheim, Deutschland.
Ophthalmologe. 2016 Jul;113(7):589-95. doi: 10.1007/s00347-015-0214-4.
The intravitreal administration of vascular endothelial growth factor (VEGF) inhibitors is the gold standard in the treatment of exudative age-related macular degeneration (AMD) but the possible risks of systemic, particularly cardiovascular side effects are still discussed.
We prospectively followed 111 patients at the University Hospital in Göttingen with exudative AMD and intravitreal ocular treatment with bevacizumab and ranibizumab during the upload phase of 3 months using a questionnaire for documentation of possible cardiovascular events.
In 5 out of 111 patients angina pectoris was observed and in 6 patients the antihypertensive medication had to be increased. No differences were found between bevacizumab and ranibizumab. A patient with pre-existing cardiovascular diseases suffered a stroke in the upload phase but no thromboembolic events were observed in the other patients.
In this small but prospective clinical study no increased risk for cardiovascular events during the upload phase of the VEGF inhibitors ranibizumab and bevacizumab could be detected when taking the age and pre-existing cardiovascular diseases into consideration.
玻璃体内注射血管内皮生长因子（VEGF）抑制剂是治疗渗出性年龄相关性黄斑变性（AMD）的金标准，但全身尤其是心血管副作用的潜在风险仍在讨论中。
在哥廷根大学医院，我们前瞻性地随访了111例渗出性AMD患者，在3个月的上调期内，使用问卷调查记录可能的心血管事件，对这些患者进行了玻璃体内注射贝伐单抗和雷珠单抗的眼部治疗。
111例患者中有5例观察到心绞痛，6例患者需要增加抗高血压药物剂量。贝伐单抗和雷珠单抗之间未发现差异。一名患有心血管疾病的患者在上调期发生了中风，但其他患者未观察到血栓栓塞事件。
在这项规模较小但具有前瞻性的临床研究中，考虑到年龄和既往心血管疾病，未发现雷珠单抗和贝伐单抗这两种VEGF抑制剂上调期心血管事件风险增加。
