Jiang Xiaodan, Wang Yuexin, Lv Huibin, Liu Yan, Zhang Mingzhou, Li Xuemin
Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
Drug Des Devel Ther. 2018 May 16;12:1269-1279. doi: 10.2147/DDDT.S146556. eCollection 2018.
To investigate the efficacy of a novel treatment - intra-meibomian gland (MG) injection of the anti-VEGF agent bevacizumab - for MG dysfunction (MGD) with eyelid-margin vascularity.
A total of 26 eyes from 13 patients diagnosed with MGD and eyelid-margin vascularity were included in our study. Patients received intra-meibomian gland injections of bevacizumab (150 μL, 2.5 mg/0.1 mL) at multiple sites with a 29 G needle where telangiectasia was severe. The Ocular Surface Disease Index (OSDI), tear film, tear-breakup time (TBUT), eyelid-margin features, MG features, conjunctiva, and corneal staining were assessed at 1 day before injection and 1 week, 1 month, and 3 months after injection. Blood pressure, best-corrected visual acuity, intraocular pressure, and slit lamp examinations were performed to assure the safety of patients at 1 day before and 1 day, 1 week, 1 month, and 3 months after injection.
Lid-margin vascularity, conjunctival injection, expressed secretion quality, expressivity of the MG, TBUT, corneal staining, and OSDI were significantly improved 1 week, 1 month, and 3 months after injection compared to baseline values. Lid-margin vascularity, conjunctival injection, meibomian gland expressivity, TBUT, and OSDI continued to improve; the greatest improvements were observed at 1 month and sustained for 3 months. Spearman's correlation analysis indicated that age and sex significantly influenced TBUT improvement. Females and older patients tended to have shorter baseline TBUT that followed a different trend from that of males and younger patients during postinjection visits, revealed by subgroup analysis. No local or systemic side effects were observed at follow-up visits.
This study is the first to explore a novel therapy for MGD - intra-MG injection of the anti-VEGF agent bevacizumab - and it demonstrates that the treatment is effective and safe in eliminating eyelid-margin vascularity, improving MG function and relieving clinical signs and symptoms of MGD.
研究一种新型治疗方法——睑板腺内注射抗血管内皮生长因子（VEGF）药物贝伐单抗——对伴有睑缘血管化的睑板腺功能障碍（MGD）的疗效。
本研究纳入了13例诊断为MGD且伴有睑缘血管化的患者的26只眼。患者在睑板腺多处严重毛细血管扩张部位，使用29G针头注射贝伐单抗（150μL，2.5mg/0.1mL）。在注射前1天以及注射后1周、1个月和3个月，评估眼表疾病指数（OSDI）、泪膜、泪膜破裂时间（TBUT）、睑缘特征、睑板腺特征、结膜和角膜染色情况。在注射前1天以及注射后1天、1周、1个月和3个月，进行血压、最佳矫正视力、眼压和裂隙灯检查，以确保患者安全。
与基线值相比，注射后1周、1个月和3个月时，睑缘血管化、结膜充血、排出分泌物质量、睑板腺排出能力、TBUT、角膜染色和OSDI均有显著改善。睑缘血管化、结膜充血、睑板腺排出能力、TBUT和OSDI持续改善；在1个月时改善最为明显，并持续3个月。Spearman相关性分析表明，年龄和性别对TBUT改善有显著影响。亚组分析显示，女性和老年患者基线TBUT往往较短，在注射后随访期间其变化趋势与男性和年轻患者不同。随访期间未观察到局部或全身副作用。
本研究首次探索了一种治疗MGD的新疗法——睑板腺内注射抗VEGF药物贝伐单抗——并证明该治疗在消除睑缘血管化、改善睑板腺功能以及缓解MGD的临床体征和症状方面是有效且安全的。
