Arevalo J Fernando, Lasave Andres F, Wu Lihteh, Maia Mauricio, Diaz-Llopis Manuel, Alezzandrini Arturo A, Brito Miguel
*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.
Retina. 2017 Feb;37(2):334-343. doi: 10.1097/IAE.0000000000001181.
To evaluate the effects of intravitreal bevacizumab (IVB) on retinal neovascularization in patients with proliferative diabetic retinopathy (PDR).
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.
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.
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.
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。
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。
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。
玻璃体内注射贝伐单抗可使接受过全视网膜光凝的PDR患者的视网膜新生血管明显消退。在24个月的随访期间，初治眼中的玻璃体内注射贝伐单抗可使42.1%的眼在未辅助激光治疗或玻璃体切除术的情况下得到控制或消退。在对PDR患者进行IVB治疗的2年随访期间，未发现安全性问题。
