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抗血管内皮生长因子玻璃体内注射疗法治疗视网膜静脉阻塞的最新进展

Update on the Use of Anti-VEGF Intravitreal Therapies for Retinal Vein Occlusions.

作者信息

Jiang Yi, Mieler William F

机构信息

University of Illinois at Chicago, Chicago, IL, United States.

出版信息

Asia Pac J Ophthalmol (Phila). 2017 Nov-Dec;6(6):546-553. doi: 10.22608/APO.2017459.

Abstract

The use of anti-vascular endothelial growth factor (VEGF) therapy in ophthalmology has profoundly changed our management and treatment of conditions such as cystoid macular edema, diabetic macular edema, choroidal neovascularization, and other proliferative retinopathies. Although initially used for the treatment of choroidal neovascularization in neovascular age-related macular degeneration, their application has spread rapidly for other indications as their outcomes have often outperformed previously existing treatments. Retinal vein occlusion (RVO) continues to be one of the leading causes of vision loss secondary to macular edema, in addition to macular ischemia and neovascularization in more severe cases. Before the availability of anti-VEGF therapy, the use of macular grid laser and panretinal photocoagulation was the mainstay of treatment of macular edema and neovascularization, respectively, in patients with RVOs. Two landmarks studies established the guidelines of these treatments for nearly a quarter century. Since the availability of anti-VEGF agents, there has been a paradigm shift in the treatment of RVO. Most importantly, there has also been a significant improvement in visual outcomes in these patients. The goal of this article is to provide a review of the pertinent clinical studies that have investigated the use of anti-VEGF in patients with retinal vein occlusions.

摘要

抗血管内皮生长因子(VEGF)疗法在眼科的应用已深刻改变了我们对诸如黄斑囊样水肿、糖尿病性黄斑水肿、脉络膜新生血管以及其他增殖性视网膜病变等病症的管理和治疗。尽管最初用于治疗新生血管性年龄相关性黄斑变性中的脉络膜新生血管,但随着其治疗效果常常优于现有治疗方法,它们在其他适应症中的应用迅速扩展。视网膜静脉阻塞(RVO)仍然是继黄斑水肿之后导致视力丧失的主要原因之一,在更严重的病例中还会出现黄斑缺血和新生血管。在抗VEGF疗法出现之前,黄斑格栅激光光凝术和全视网膜光凝术分别是RVO患者黄斑水肿和新生血管治疗的主要手段。两项具有里程碑意义的研究确立了近四分之一个世纪这些治疗的指南。自从有了抗VEGF药物,RVO的治疗发生了范式转变。最重要的是,这些患者的视觉效果也有了显著改善。本文的目的是对研究抗VEGF在视网膜静脉阻塞患者中应用的相关临床研究进行综述。

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