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贝伐单抗(阿瓦斯汀)与热激光联合治疗视乳头周围脉络膜新生血管膜

Bevacizumab (Avastin) and Thermal Laser Combination Therapy for Peripapillary Choroidal Neovascular Membranes.

作者信息

Adrean Sean D, Grant Scott, Chaili Siyang

机构信息

Retina Consultants of Orange County, Fullerton, CA, USA.

The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

出版信息

J Ophthalmol. 2017;2017:4802690. doi: 10.1155/2017/4802690. Epub 2017 Mar 26.

Abstract

. This is a retrospective interventional case series describing the results of 5 eyes from 5 patients with symptomatic peripapillary choroidal neovascularization (CNVM) receiving initial bevacizumab treatment followed by thermal laser and bevacizumab combination therapy. . Patients received intravitreal bevacizumab injections until the lesions were well-defined. Thermal laser ablation was then administered and followed by an additional bevacizumab injection after one week. Visual outcomes, OCT changes, and rates of recurrence were recorded and analyzed. . Median visual outcomes improved from 20/50 to 20/30 ( = 0.0232). Median central macular thickness decreased from 347 m to 152 m ( = 0.0253). The mean visual improvement was 3 lines. An average of 3.8 bevacizumab injections per patient were given overall. Patients were followed for an average of 24 months, during which all eyes were absent for recurrence. . Symptomatic peripapillary CNVM may be successfully managed with bevacizumab followed by a combination of thermal laser and bevacizumab without the need for frequent retreatment. The area requiring treatment may be better defined using bevacizumab, limiting the ablation of the healthy retina and improving treatment margins. With this treatment regimen, the patients experience improved visual outcomes and have a low rate of recurrence.

摘要

这是一项回顾性介入病例系列研究,描述了5例有症状的视乳头周围脉络膜新生血管(CNVM)患者的5只眼睛接受初始贝伐单抗治疗,随后进行热激光和贝伐单抗联合治疗的结果。患者接受玻璃体内贝伐单抗注射,直到病变清晰界定。然后进行热激光消融,一周后再注射一次贝伐单抗。记录并分析视觉结果、光学相干断层扫描(OCT)变化和复发率。中位视觉结果从20/50提高到20/30(P = 0.0232)。黄斑中心厚度中位数从347μm降至152μm(P = 0.0253)。平均视力提高3行。每位患者总体平均接受3.8次贝伐单抗注射。患者平均随访24个月,在此期间所有眼睛均无复发。有症状的视乳头周围CNVM可以通过贝伐单抗治疗,随后联合热激光和贝伐单抗成功治疗,无需频繁再次治疗。使用贝伐单抗可以更好地界定需要治疗的区域,限制对健康视网膜的消融并改善治疗边界。采用这种治疗方案,患者的视觉结果得到改善,复发率较低。

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