Ivanovska Adjievska Biljana, Boskurt Salih, Orovcanec Nikola, Dimovska-Jordanova Vesna
Department for Posterior Segment, European Eye Hospital, Skopje, Republic of Macedonia.
Department for Medical Statistics, Institute for Epidemiology and Medical Statistics, Medical Faculty, Skopje, Republic of Macedonia.
Clin Ophthalmol. 2017 Jun 21;11:1183-1190. doi: 10.2147/OPTH.S137380. eCollection 2017.
We aimed to evaluate the 1-year efficacy and safety of low-frequency intravitreal bevacizumab in the treatment of macular edema due to retinal vein occlusions (RVOs).
The study comprised an interventional prospective study of patients with macular edema due to central retinal vein occlusion (CRVO) or branch retinal vein occlusion, followed for 12 months. Treatment-naïve patients with reduced best-corrected visual acuity (BCVA) and central macular thickness (CMT) of at least 250 μm received intravitreal injection of bevacizumab. After 1 month, BCVA and optical coherence tomography (OCT) images of the macula were recorded. In patients with <30% improvement in BCVA and CMT, two more injections were applied at 1.5-month intervals. In all other patients, further injections were applied as needed. In cases with ischemic areas of retina, laser photocoagulation of the retina was performed.
In total, 33 patients with CRVO and 55 with BRVO were treated. After 1 year, 65 eyes (73.86%) had clinically significant improvement of BCVA (>0.3 log of the minimum angle of resolution [logMAR] units) with average number of injections of 1.98. Improvement of mean BCVA in CRVO was significant (=0.001) from baseline (1.2±0.95 logMAR units) to 1 year (0.75±0.6 logMAR units). Significant improvement of mean BCVA (<0.001) was also found in BRVO, from 0.71±0.75 logMAR units at baseline to 0.28±0.5 logMAR units at 1 year. Baseline CMT was 852.21±298.20 μm for CRVO and 597.95±185.63 μm for BRVO. In both groups, there was significant decrease (<0.001) in CMT after 1 year of treatment. Panretinal laser photocoagulation was done in 75.8% of all eyes with CRVO and sectoral photocoagulation in 49.1% of eyes with BRVO.
In macular edema due to RVO, intravitreal bevacizumab provides improvement in visual acuity and reduction of macular edema in a high percentage of treated eyes after 1 year, even with low number of injections.
我们旨在评估低频玻璃体内注射贝伐单抗治疗视网膜静脉阻塞（RVO）所致黄斑水肿的1年疗效和安全性。
该研究为一项针对中心性视网膜静脉阻塞（CRVO）或视网膜分支静脉阻塞所致黄斑水肿患者的前瞻性干预性研究，随访12个月。初治的最佳矫正视力（BCVA）降低且中心黄斑厚度（CMT）至少为250μm的患者接受玻璃体内注射贝伐单抗。1个月后，记录BCVA和黄斑区的光学相干断层扫描（OCT）图像。BCVA和CMT改善不足30%的患者，每隔1.5个月再注射两次。在所有其他患者中，根据需要进行进一步注射。对于存在视网膜缺血区的病例，进行视网膜激光光凝治疗。
总共治疗了33例CRVO患者和55例BRVO患者。1年后，65只眼（73.86%）的BCVA有临床显著改善（最小分辨角对数[logMAR]单位提高>0.3），平均注射次数为1.98次。CRVO患者从基线时的平均BCVA（1.2±0.95 logMAR单位）到1年时（0.75±0.6 logMAR单位）有显著改善（=0.001）。BRVO患者的平均BCVA也有显著改善（<0.001），从基线时的0.71±0.75 logMAR单位到1年时的0.28±0.5 logMAR单位。CRVO患者的基线CMT为852.21±298.20μm，BRVO患者为597.95±185.63μm。两组在治疗1年后CMT均有显著下降（<0.001）。所有CRVO眼中75.8%进行了全视网膜激光光凝，BRVO眼中49.1%进行了局部光凝。
在RVO所致黄斑水肿中，玻璃体内注射贝伐单抗即使注射次数较少，1年后仍能使高比例的治疗眼视力提高、黄斑水肿减轻。
