Khatri Anadi, Karki Pratap, Joshi Sagun Narayan, Kharel Sitaula Ranju
Department of Ophthalmology, Birat Eye Hospital, Biratnagar, Nepal.
Department of Ophthalmology, B P Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
BMJ Open Ophthalmol. 2017 Dec 10;2(1):e000102. doi: 10.1136/bmjophth-2017-000102. eCollection 2017.
Antivascular endothelial growth factor (anti-VEGFs)-bevacizumab is routinely utilised for the treatment of diabetic macular oedema (DME). We plan to evaluate the impact of bevacizumab on the central subfield macular thickness (CSMT) of the treated and untreated eye.
A sequential group of patients with bilateral DME who were treated with unilateral bevacizumab injection were assessed preinjection and postinjection by Spectral Domain-Optical Coherence Tomography (SD-OCT) by CSMT.
Thirty-one patients, 20 male and 11 female, were evaluated. Seven patients had type 1 diabetes mellitus and 24 had type 2 diabetes mellitus. In regard to the duration of disease, 23 patients had diabetes for more than 10 years, seven patients had the condition for 5-10 years and one patient for more than 5 years. Mean age of the patients was 60.48 years (SD±7.13) with the range of 46-72 years. Mean follow-up was 28 days (range 26-35 days). The eyes which received intravitreal injection had median CSMT of 473.2 µm(range 321-566 µm). The CSMT of the contralateral eye had median of 347.6 µm (range 357-437 µm). A median reduction of -132 µm (range 93-156 µm) could be observed in the treated eye and -18 µm (range 15-22) in the untreated eye after treatment. Our study also found that eyes with greater CSMT, when injected with bevacizumab, produced higher responses in the contralateral eye (R 0.538, P<0.05).
Patients with bilateral DME treated with bevacizumab in one eye produced a bilateral response. Eyes with greater CSMT due to DME elicited higher levels of response in the untreated eye.
抗血管内皮生长因子（抗VEGF）药物贝伐单抗常用于治疗糖尿病性黄斑水肿（DME）。我们计划评估贝伐单抗对治疗眼和未治疗眼的黄斑中心凹厚度（CSMT）的影响。
对一组接受单侧贝伐单抗注射治疗的双侧DME患者，在注射前和注射后通过光谱域光学相干断层扫描（SD-OCT）测量CSMT进行评估。
共评估了31例患者，其中男性20例，女性11例。7例为1型糖尿病患者，24例为2型糖尿病患者。就病程而言，23例患者糖尿病病程超过10年，7例患者病程为5至10年，1例患者病程超过5年。患者的平均年龄为60.48岁（标准差±7.13），年龄范围为46至72岁。平均随访时间为28天（范围为26至35天）。接受玻璃体腔注射的眼的CSMT中位数为473.2µm（范围为321至566µm）。对侧眼的CSMT中位数为347.6µm（范围为357至437µm）。治疗后，治疗眼的CSMT中位数减少了-132µm（范围为93至156µm），未治疗眼减少了-18µm（范围为15至22µm）。我们的研究还发现，CSMT较高的眼在注射贝伐单抗后，对侧眼产生的反应更高（R=0.538，P<0.05）。
单眼接受贝伐单抗治疗的双侧DME患者出现了双侧反应。因DME导致CSMT较高的眼在未治疗眼中引发了更高水平的反应。
