玻璃体内注射贝伐单抗治疗增殖性糖尿病视网膜病变：泛美视网膜协作研究组（PACORES）24个月随访结果

INTRAVITREAL BEVACIZUMAB FOR PROLIFERATIVE DIABETIC RETINOPATHY: Results From the Pan-American Collaborative Retina Study Group (PACORES) at 24 Months of Follow-up.

作者信息

Arevalo J Fernando, Lasave Andres F, Wu Lihteh, Maia Mauricio, Diaz-Llopis Manuel, Alezzandrini Arturo A, Brito Miguel

机构信息

*Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD; †Retina and Vitreous Service, Clínica Privada de Ojos, Mar del Plata, Argentina; ‡Instituto de Cirugia Ocular, San Jose, Costa Rica; §Departamento de Oftalmologia, Instituto da Visão, Universidade Federal de São Paulo, São Paulo, Brazil; ¶Consorcio Hospital, General Universitario de Valencia, Valencia, Spain; **Facultad de Medicina, OFTALMOS, Universidad de Buenos Aires, Buenos Aires, Argentina; and ††Instituto Docente de Especialidades Oftalmológicas (IDEO), Maracaibo, Venezuela.

出版信息

Retina. 2017 Feb;37(2):334-343. doi: 10.1097/IAE.0000000000001181.

DOI:10.1097/IAE.0000000000001181

PMID:27429384

Abstract

PURPOSE

To evaluate the effects of intravitreal bevacizumab (IVB) on retinal neovascularization in patients with proliferative diabetic retinopathy (PDR).

METHODS

Retrospective multicenter interventional case series. A chart review was performed of 81 consecutive patients (97 eyes) with retinal neovascularization due to PDR, who received at least 1 IVB injection.

RESULTS

The mean age of the patients was 55.6 ± 11.6 years. The mean number of IVB injections was 4 ± 2.5 injections (range, 1-8 injections) per eye. The mean interval between IVB applications was 3 ± 7 months. The mean duration of follow-up was 29.6 ± 2 months (range, 24-30 months). Best-corrected visual acuity and optical coherence tomography improved statistically significantly (P < 0.0001, both comparisons). Three eyes without previous panretinal photocoagulation ("naive" eyes) and with vitreous hemorrhage did not require vitreoretinal surgery. Five (5.2%) eyes with PDR progressed to tractional retinal detachment requiring vitrectomy. No systemic adverse events were noted.

CONCLUSION

Intravitreal bevacizumab resulted in marked regression of retinal neovascularization in patients with PDR and previous panretinal photocoagulation. Intravitreal bevacizumab in naive eyes resulted in control or regression of 42.1% of eyes without adjunctive laser or vitrectomy during 24 months of follow-up. There were no safety concerns during the 2 years of follow-up of IVB for PDR.

摘要

目的

评估玻璃体内注射贝伐单抗（IVB）对增殖性糖尿病视网膜病变（PDR）患者视网膜新生血管形成的影响。

方法

回顾性多中心干预性病例系列研究。对81例（97只眼）因PDR导致视网膜新生血管形成且接受至少1次IVB注射的连续患者进行病历回顾。

结果

患者的平均年龄为55.6±11.6岁。每只眼IVB注射的平均次数为4±2.5次（范围为1 - 8次）。IVB注射之间的平均间隔为3±7个月。平均随访时间为29.6±2个月（范围为24 - 30个月）。最佳矫正视力和光学相干断层扫描在统计学上有显著改善（两次比较P均<0.0001）。3只未接受过全视网膜光凝的“初治”眼且伴有玻璃体积血的患者无需进行玻璃体视网膜手术。5只（5.2%）PDR眼进展为牵拉性视网膜脱离，需要进行玻璃体切除术。未观察到全身性不良事件。