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玻璃体内注射贝伐单抗在视网膜静脉阻塞继发的非缺血性黄斑水肿中的“超说明书”使用。

"Off-label" use of intravitreal bevacizumab in non-ischemic macular edema secondary to retinal vein obstructions.

作者信息

Dascalu Ana Maria, Popa-Cherecheanu Alina, Popa-Cherecheanu Matei, Nica Adriana, Serban Dragos

机构信息

"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania Department of Ophthalmology, University Emergency Hospital Bucharest, Romania.

出版信息

Rom J Ophthalmol. 2016 Apr-Jun;60(2):90-95.

Abstract

OBJECTIVE

To evaluate the safety and efficacy of intravitreal Bevacizumab in treatment of non-ischemic macular edema secondary to retinal vein obstruction (RVO).

MATERIALS AND METHODS

A 2-year-retrospective study was performed on 26 patients hospitalized for non-ischemic macular edema secondary to RVO. All the patients underwent a complete ophthalmologic exam, with best corrected visual acuity (BCVA) testing, fundus photography, fluorescein angiography (FA) and macular thickness measurement by optical coherence tomography (OCT). Reevaluation was performed monthly for VA, OCT, and ophthalmoscopy and, at every 3 months, by FA. A standard protocol of 0.05 ml intravitreal Bevacizumab injection was applied. Further administrations were performed according to clinical evolution.

RESULTS

The medium follow-up period was of 9,7 months (6-20 months). There were no significant complications following the procedure. The number of intravitreal Bevacizumab injections varied from 2-5/ patient. All the patients experienced an improvement in VA and a significant regression of macular edema. The smallest number of intravitreal Bevacizumab injections and the best visual prognosis were observed in cases with branch retinal vein obstruction (BRVO) and early presentation (p<0.05).

CONCLUSIONS

As a pathogenic therapy, intravitreal Bevacizumab is a safe, repeatable procedure and it may be considered an effective and lasting treatment for non-ischemic macular edema secondary to RVO. Intravitreal Bevacizumab should be included in the therapeutic protocol of RVO, both for early and delayed presentations. RVO = retinal vein obstruction, BRVO = branch retinal vein obstruction, CRVO = central retinal branch obstruction, BCVA = best corrected visual acuity, FA = fluorescein angiography, OCT = optical coherence tomography.

摘要

目的

评估玻璃体内注射贝伐单抗治疗视网膜静脉阻塞(RVO)继发的非缺血性黄斑水肿的安全性和有效性。

材料与方法

对26例因RVO继发非缺血性黄斑水肿住院的患者进行了为期2年的回顾性研究。所有患者均接受了全面的眼科检查,包括最佳矫正视力(BCVA)测试、眼底照相、荧光素血管造影(FA)以及通过光学相干断层扫描(OCT)测量黄斑厚度。每月对视力、OCT和检眼镜进行复查,每3个月进行一次FA复查。采用0.05 ml玻璃体内注射贝伐单抗的标准方案。根据临床进展进行进一步给药。

结果

平均随访期为9.7个月(6 - 20个月)。术后无明显并发症。玻璃体内注射贝伐单抗的次数为每位患者2 - 5次。所有患者的视力均有改善,黄斑水肿明显消退。在视网膜分支静脉阻塞(BRVO)和早期发病的病例中,观察到玻璃体内注射贝伐单抗的次数最少且视力预后最佳(p<0.05)。

结论

作为一种致病疗法,玻璃体内注射贝伐单抗是一种安全、可重复的操作,可被视为治疗RVO继发非缺血性黄斑水肿的有效且持久的治疗方法。玻璃体内注射贝伐单抗应纳入RVO的治疗方案,无论是早期还是延迟发病情况。RVO = 视网膜静脉阻塞,BRVO = 视网膜分支静脉阻塞,CRVO = 视网膜中央静脉阻塞,BCVA = 最佳矫正视力,FA = 荧光素血管造影,OCT = 光学相干断层扫描

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