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血管样条纹所致脉络膜新生血管的玻璃体内按需抗血管内皮生长因子治疗长期随访

Long-Term Follow-Up of Choroidal Neovascularization due to Angioid Streaks with pro re nata Intravitreal Anti-VEGF Treatment.

作者信息

Giacomelli Giovanni, Finocchio Lucia, Biagini Ilaria, Sodi Andrea, Murro Vittoria, Introini Ugo, Varano Monica, Bandello Francesco, Menchini Ugo

机构信息

Department of Translational Surgery and Medicine, Eye Clinic, University of Florence, Florence, Italy.

出版信息

Ophthalmologica. 2017;238(1-2):44-51. doi: 10.1159/000477498. Epub 2017 Jun 23.

Abstract

PURPOSE

To evaluate the long-term outcomes of intravitreal anti-vascular endothelial growth factor (VEGF) drugs with a pro re nata (PRN) regimen for the treatment of choroidal neovascularization (CNV) secondary to angioid streaks (AS).

METHODS

This is a retrospective, multicenter, noncomparative case series of consecutive AS eyes affected by treatment-naïve CNV. A complete ophthalmologic examination was performed every 30-45 days after the loading phase, including fluorescein angiography and/or optical coherence tomography.

RESULTS

In all, 52 eyes of 39 patients were treated with intravitreal bevacizumab and/or ranibizumab and followed up for a mean of 33.8 months. The best corrected visual acuity at baseline was 20/40, and it deteriorated by an average of 6.8 ETDRS letters per year (p < 0.001). We performed an average of 5.1, 6.5, and 6.8 injections at the 1-, 2-, and 3-year follow-up, respectively.

CONCLUSIONS

Intravitreal anti-VEGF drugs in a PRN regimen with close monitoring appear to slow the progression of CNV in AS, but they do not prevent the affected eyes from progressive visual loss.

摘要

目的

评估按需(PRN)给药方案的玻璃体内抗血管内皮生长因子(VEGF)药物治疗血管样条纹(AS)继发脉络膜新生血管(CNV)的长期疗效。

方法

这是一项回顾性、多中心、非对照病例系列研究,纳入未经治疗的AS继发CNV的连续病例。负荷期后每30 - 45天进行一次全面眼科检查,包括荧光素血管造影和/或光学相干断层扫描。

结果

共有39例患者的52只眼接受了玻璃体内贝伐单抗和/或雷珠单抗治疗,平均随访33.8个月。基线时最佳矫正视力为20/40,每年平均下降6.8个ETDRS字母(p < 0.001)。在1年、2年和3年随访时分别平均注射5.1次、6.5次和6.8次。

结论

在密切监测下采用按需给药方案的玻璃体内抗VEGF药物似乎可减缓AS继发CNV的进展,但不能防止患眼视力逐渐丧失。

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