Ha Jun Young, Lee Tae Hee, Sung Mi Sun, Park Sang Woo
Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Korea.
Korean J Ophthalmol. 2017 Dec;31(6):538-547. doi: 10.3341/kjo.2017.0017. Epub 2017 Oct 20.
To evaluate the long-term efficacy and safety of intracameral bevacizumab in patients with neovascular glaucoma.
This retrospective study included 26 eyes of 26 neovascular glaucoma patients who received intracameral bevacizumab injection between January 2013 and May 2015, and were followed-up for at least 1 year. All patients were treated with topical and/or systemic intraocular pressure (IOP)-lowering medications, intracameral bevacizumab, and panretinal photocoagulation (PRP). The main outcome measures were changes in visual acuity, IOP, and neovascularization of the iris (NVI) and the anterior chamber angle (NVA). To assess the safety of intracameral bevacizumab, corneal endothelial changes were also determined using specular microscopy. Patients whose IOP was uncontrolled received IOP-lowering surgery. Clinical factors associated with IOP-lowering surgery were also investigated.
In all patients, intracameral bevacizumab resulted in a rapid and marked reduction of IOP, NVI, and NVA within 1 week. At 12 months after initial injection, 19 of 26 eyes (73%) underwent IOP-lowering surgery. The average interval between initial injection and surgical treatment was 33.6 ± 26.9 days. Baseline IOP (p = 0.018), NVA grade (p = 0.029), and incomplete PRP (p = 0.005) were identified as predictive factors for IOP-lowering surgery. During the follow-up period, there were no statistically significant corneal endothelial changes after intracameral bevacizumab injection.
During 1 year of follow-up after intracameral bevacizumab, the procedure was found to be safe for the corneal endothelium. However, the IOP-lowering effect was transient, and 73% of patients eventually required IOP-lowering surgery. Predictive factors for IOP-lowering surgery were high baseline IOP and NVA grade, and incomplete PRP.
评估前房内注射贝伐单抗治疗新生血管性青光眼患者的长期疗效和安全性。
本回顾性研究纳入了2013年1月至2015年5月期间接受前房内注射贝伐单抗治疗且随访至少1年的26例新生血管性青光眼患者的26只眼。所有患者均接受局部和/或全身降眼压药物、前房内注射贝伐单抗及全视网膜光凝（PRP）治疗。主要观察指标为视力、眼压、虹膜新生血管（NVI）及前房角新生血管（NVA）的变化。为评估前房内注射贝伐单抗的安全性，还使用角膜内皮显微镜检查确定角膜内皮变化。眼压控制不佳的患者接受降眼压手术。还研究了与降眼压手术相关的临床因素。
在所有患者中，前房内注射贝伐单抗在1周内使眼压、NVI和NVA迅速且显著降低。初次注射后12个月，26只眼中的19只（73%）接受了降眼压手术。初次注射与手术治疗之间的平均间隔为33.6±26.9天。基线眼压（p = 0.018）、NVA分级（p = 0.029）和不完全PRP（p = 0.005）被确定为降眼压手术的预测因素。在随访期间，前房内注射贝伐单抗后角膜内皮无统计学显著变化。
在前房内注射贝伐单抗后的1年随访期间，该操作对角膜内皮是安全的。然而，降眼压效果是短暂的，73%的患者最终需要降眼压手术。降眼压手术的预测因素为高基线眼压和NVA分级以及不完全PRP。
