Mohamed Tarek A, Soliman Wael, Fathalla Ahmed M, El Refaie Abeer
Department of Ophthalmology, Assiut University Hospital, Assiut 71111, Egypt.
Department of Pathology, Faculty of Medicine, Assiut University, Assiut 71111, Egypt.
Int J Ophthalmol. 2018 May 18;11(5):797-801. doi: 10.18240/ijo.2018.05.13. eCollection 2018.
To evaluate the effect (clinically, histopathologically and immunohistochemically) and safety of a single intra-pterygium injection of bevacizumab.
Prospective interventional study comprised 40 eyes of 40 patients with primary fleshy pterygia who attended the Outpatient Clinic of Department of Ophthalmology, Assiut University Hospitals, Egypt from May 2015 to May 2016. Patients were randomly classified into 2 groups: the first group received a single intralesional injection of bevacizumab (Avastin; Genentech, San Francisco, CA, USA); the second group comprised patients who did not receive subconjunctival bevacizumab. Excision of pterygium and conjunctival auto graft was done in both groups. The excised pterygium tissues were subjected to histopathological and immunohistochemical evaluation.
The study comprised 40 eyes of 40 patients (33 men, 7 women) of age range from 31-58y. The study group included 22 eyes. The control group included 18 eyes. A decrease in the vascularity of the pterygium was noted in all injected cases. The mean vessel count was higher in non-injected pterygia than that in injected pterygia and the difference was statistically significant (=0.001). Also, the mean vessel count in both groups was significantly higher than normal conjunctive (=0.005 and 0.001). A statistically significant difference in vascular endothelial growth factor (VEGF) expression between injected and non-injected cases was detected in the epithelial, stromal and endothelial cells (=0.0001, 0.016, 0.014). No serious intraoperative complications occurred in both groups.
The use of single intra lesional injection of Avastin in pterygium decreased vascularity and decreased VEGF expression in injected pterygium after one month. Our study proved the effect of single intra lesional injection of Avastin on pterygium. Further studies may enable limiting the need for surgery and improve quality of life for patients with pterygia.
评估在翼状胬肉内单次注射贝伐单抗的效果（临床、组织病理学和免疫组织化学方面）及安全性。
前瞻性干预性研究纳入了2015年5月至2016年5月在埃及阿斯尤特大学医院眼科门诊就诊的40例原发性肉质翼状胬肉患者的40只眼。患者被随机分为2组：第一组接受在病变内单次注射贝伐单抗（阿瓦斯汀；基因泰克公司，美国加利福尼亚州旧金山）；第二组为未接受结膜下贝伐单抗注射的患者。两组均进行翼状胬肉切除术及结膜自体移植术。对切除的翼状胬肉组织进行组织病理学和免疫组织化学评估。
该研究纳入了40例患者的40只眼（男性33例，女性7例），年龄范围为31 - 58岁。研究组包括22只眼。对照组包括18只眼。在所有注射病例中均观察到翼状胬肉血管化程度降低。未注射的翼状胬肉的平均血管计数高于注射的翼状胬肉，差异具有统计学意义（P = 0.001）。此外，两组的平均血管计数均显著高于正常结膜（P = 0.005和0.001）。在注射和未注射病例的上皮细胞、基质细胞和内皮细胞中，血管内皮生长因子（VEGF）表达存在统计学显著差异（P = 0.0001、0.016、0.014）。两组均未发生严重的术中并发症。
在翼状胬肉内单次注射阿瓦斯汀一个月后，可降低注射部位翼状胬肉的血管化程度并降低VEGF表达。我们的研究证实了在翼状胬肉内单次注射阿瓦斯汀的效果。进一步的研究可能会减少手术需求并改善翼状胬肉患者的生活质量。
