Sugimoto Masahiko, Ichio Atsushi, Nunome Takayasu, Kondo Mineo
Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Medicine (Baltimore). 2017 Apr;96(16):e6406. doi: 10.1097/MD.0000000000006406.
To determine the efficacy of the treat and extend (TAE) protocol with intravitreal bevacizumab (IVB) for managing diabetic macular edema (DME).Retrospective, single-center study.For this retrospective study, 42 eyes of 42 patients were initially treated with 3 consecutive monthly IVB injections (loading phase), after which they were selected for different additional therapies. For the TAE protocol, the baseline treatment interval was selected to be 8 weeks and was sequentially lengthened by 2 weeks if the central macular thickness (CMT) was <300 μm at 2 consecutive examinations.Among the 42 eyes, 8 eyes (19.0%) received the TAE treatment for 2 years. The BCVA was improved significantly from 0.37 ± 0.04 before treatment to 0.19 ± 0.04 logMAR units at 2 years after the TAE determined IVB injections (P < .05). The ratio of eyes with a gain of the BCVA by more than 2 lines was 37.5%. The CMT was significantly reduced from 515.4 ± 75.5 to 303.6 ± 45.0 μm after 2 years (P < .01). The mean number of TAE injection was 8.8 and the mean injection interval was 11.0 weeks.After the loading phase, 19.0% of patients can be treated with the TAE protocol. Although significant visual improvements were obtained after the TAE protocol, it does not apply to every DME case.
为确定玻璃体内注射贝伐单抗(IVB)的治疗并延长(TAE)方案治疗糖尿病性黄斑水肿(DME)的疗效。回顾性单中心研究。在这项回顾性研究中,42例患者的42只眼最初连续3个月每月接受一次IVB注射(负荷期),之后为其选择不同的附加治疗。对于TAE方案,基线治疗间隔选择为8周,如果连续2次检查时中心黄斑厚度(CMT)<300μm,则依次延长2周。42只眼中,8只眼(19.0%)接受TAE治疗2年。最佳矫正视力(BCVA)从治疗前的0.37±0.04显著改善至TAE确定的IVB注射后2年时的0.19±0.04 logMAR单位(P<0.05)。BCVA提高超过2行的眼的比例为37.5%。2年后CMT从515.4±75.5显著降至303.6±45.0μm(P<0.01)。TAE注射的平均次数为8.8次,平均注射间隔为11.0周。负荷期后,19.0%的患者可采用TAE方案治疗。虽然TAE方案后视力有显著改善,但它并不适用于每一例DME病例。