Ghassemi Fariba, Mirak Sohrab Afshari, Chams Hormoz, Sabour Siamak, Ahmadabadi Mehdi Nilli, Davatchi Fereidoun, Shahram Farhad
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; The Retina and vitreous surgery service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Ophthalmic Vis Res. 2017 Jan-Mar;12(1):44-52. doi: 10.4103/jovr.jovr_254_15.
To investigate the effect of intravitreal bevacizumab (IVB) injection on macular edema (ME) secondary to Behcet's disease.
This prospective case series included 15 patients with bilateral ME due to Behcet's disease. Intravitreal bevacizumab was injected into the more severely involved eye; the contralateral eye was evaluated as the control. Patients were followed up with comprehensive ocular examination, optical coherence tomography, and fluorescein angiography (FA) for a minimum of 6 months by a single ophthalmologist.
Patients with a mean age of 30.6 ± 7.4 years received a mean number of 3.3 IVB injections during the 6 months. The mean preinjection vision was 0.6 ± 0.3 and 0.4 ± 0.4 LogMAR in the case and control groups, respectively, with no significant improvement at 6 months. Mean central foveal thickness was 375.3 ± 132.1 and 307.2 ± 84.5 μm in the case and control groups, respectively, and these changed to 401 ± 199.9 ( = 0.65) and 307.7 ± 82.8 μm ( = 0.73) at month 6, respectively. A statistically nonsignificant improvement in ME was observed during the first 3 months in the case group. However, it did not persist up to month 6 on an as-needed basis. IVB injections caused a disproportionate decrease in the thickness of macular subfields. A reduction in disc leakage was observed on FA ( = 0.058). Logistic regression analysis revealed no statistically significant predictive factor for an improvement in visual acuity (VA) and a reduction in foveal thickness.
During a 6-month period, IVB injections based on an as-needed protocol provided no statistically significant improvement in VA and ME.
探讨玻璃体内注射贝伐单抗(IVB)治疗白塞病继发黄斑水肿(ME)的效果。
本前瞻性病例系列研究纳入了15例双侧白塞病继发ME的患者。向病情较重的患眼玻璃体内注射贝伐单抗;对侧眼作为对照。由一名眼科医生对患者进行至少6个月的综合眼科检查、光学相干断层扫描和荧光素血管造影(FA)随访。
患者平均年龄为30.6±7.4岁,在6个月内平均接受3.3次IVB注射。病例组和对照组注射前平均视力分别为0.6±0.3和0.4±0.4 LogMAR,6个月时无显著改善。病例组和对照组平均中心凹厚度分别为375.3±132.1和307.2±84.5μm,在第6个月时分别变为401±199.9(P = 0.65)和307.7±82.8μm(P = 0.73)。病例组在最初3个月观察到ME有统计学上无显著意义的改善。然而,按需治疗至第6个月时这种改善未持续。IVB注射导致黄斑亚区厚度不成比例地降低。FA显示视盘渗漏减少(P = 0.058)。逻辑回归分析显示,在视力(VA)改善和中心凹厚度降低方面,没有统计学上显著的预测因素。
在6个月期间,按需方案的IVB注射在VA和ME方面没有统计学上的显著改善。