Kasahara Kaori, Moriyama Muka, Morohoshi Kei, Yoshida Takeshi, Simada Noriaki, Nagaoka Natsuko, Yokoi Tae, Shinohara Kosei, Kaneko Yuichiro, Suga Mitsuki, Ohno-Matsui Kyoko
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Retina. 2017 Jun;37(6):1055-1064. doi: 10.1097/IAE.0000000000001313.
To investigate the 6-year outcome of intravitreal bevacizumab (IVB) to treat eyes with active choroidal neovascularization (CNV) due to pathologic myopia.
Medical records of 36 eyes of 35 consecutive patients with high myopia (refractive error ≥8 D or axial length ≥26.5 mm) and active CNV, who had been treated with IVB and followed for ≥6 years were analyzed. The factors that predicted the best-corrected visual acuity (BCVA) at 6 years after IVB were determined by multiple regression analyses.
The mean age of the subjects was 58 years, and the mean axial length was 29 mm. Twenty-one eyes had subfoveal CNV and 15 eyes had nonsubfoveal CNV. During the 6-year follow-up, the mean number of IVB was 1.78. The mean BCVA logMAR (equivalent Snellen visual acuity) was 0.50 (20/63), 0.31 (20/40), 0.39 (20/50), and 0.45 (20/63) at the baseline, and at 2, 4, and 6 years after the IVB. The BCVA was significantly improved at 2 and 4 years compared with baseline values but not at 6 years. Stepwise multiple regression analyses showed that the BVCA at 6 years was significantly correlated with the size of the CNV-related macular atrophy, and the baseline BCVA and CNV size.
The significant correlation between the BCVA at 6 years and the size of the macular atrophy indicates that treatments to prevent the development of macular atrophy are important for the long-term visual outcome in eyes with active CNV.
探讨玻璃体内注射贝伐单抗（IVB）治疗病理性近视所致活动性脉络膜新生血管（CNV）眼的6年疗效。
分析35例连续的高度近视（屈光不正≥8 D或眼轴长度≥26.5 mm）且患有活动性CNV并接受IVB治疗且随访≥6年的患者的36只眼的病历。通过多元回归分析确定预测IVB治疗后6年最佳矫正视力（BCVA）的因素。
受试者的平均年龄为58岁，平均眼轴长度为29 mm。21只眼有黄斑中心凹下CNV，15只眼有黄斑中心凹外CNV。在6年的随访期间，IVB的平均注射次数为1.78次。在基线时以及IVB治疗后2年、4年和6年时，平均BCVA的logMAR（等效斯内伦视力）分别为0.50（20/63）、0.31（20/40）、0.39（20/50）和0.45（20/63）。与基线值相比，BCVA在2年和4年时显著改善，但在6年时未改善。逐步多元回归分析显示，6年时的BCVA与CNV相关黄斑萎缩的大小、基线BCVA和CNV大小显著相关。
6年时的BCVA与黄斑萎缩大小之间的显著相关性表明，预防黄斑萎缩发展的治疗对于活动性CNV眼的长期视力预后很重要。
