Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.
Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA.
Ocul Surf. 2019 Jan;17(1):134-141. doi: 10.1016/j.jtos.2018.11.008. Epub 2018 Nov 20.
To report the long-term outcome of Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) for delivery of bevacizumab in the treatment of corneal neovascularization (KNV).
Retrospective, non-comparative, interventional case series of 13 sequential patients treated for KNV at the BostonSight between 2006 and 2017. In all cases, PROSE treatment was initiated for management of ocular surface disease and patients wore PROSE consistently on a daily wear basis prior to bevacizumab treatment. Patients applied a drop of 1% preservative free bevacizumab to the reservoir of PROSE device twice daily. Patients continued with daily wear of the device during treatment and afterwards.
13 patients (8 female and mean age of 45 years) are included with a mean follow-up of 5.1 years (range 6 months-11 years). Underlying ocular diagnoses included Stevens-Johnson syndrome (7), ocular chronic graft-versus-host disease (2), corneal transplant (2), contact lens-related corneal ulcer and limbal stem cell deficiency (1), and familial dysautonomia (1). Median duration of bevacizumab use was 6 months (range 3 months-10 years). Twelve cases (92%) had regression of KNV and 10 cases (77%) had improved best-corrected visual acuity (BCVA) with treatment. Median BCVA improved from -1.1 (LogMAR) at baseline, to -0.66 at end of bevacizumab treatment, and remained -0.63 at last follow-up (P = 0.047). KNV progressed in one eye after discontinuation of bevacizumab. There were no ophthalmic or systemic complications.
Topical bevacizumab used in PROSE is effective in treating KNV and improving vision. Long-term follow-up reveals durable response and no complications.
报告 Prosthetic Replacement of the Ocular Surface Ecosystem（PROSE）用于贝伐单抗递送治疗角膜新生血管（KNV）的长期疗效。
回顾性、非对照、干预性病例系列研究，纳入 2006 年至 2017 年在波士顿视力中心接受 KNV 治疗的 13 例连续患者。在所有病例中，均因眼表疾病开始 PROSE 治疗，在接受贝伐单抗治疗前，患者每日持续佩戴 PROSE。患者将 1%无防腐剂的贝伐单抗滴入 PROSE 装置储液器中，每日两次。在治疗期间和之后，患者继续每日佩戴该设备。
共纳入 13 例患者（8 名女性，平均年龄 45 岁），平均随访时间为 5.1 年（6 个月至 11 年）。潜在的眼部诊断包括 Stevens-Johnson 综合征（7 例）、眼慢性移植物抗宿主病（2 例）、角膜移植（2 例）、接触镜相关角膜溃疡和角膜缘干细胞缺乏症（1 例）、家族性自主神经异常（1 例）。贝伐单抗使用的中位时间为 6 个月（3 个月至 10 年）。12 例（92%）患者的 KNV 消退，10 例（77%）患者的最佳矫正视力（BCVA）改善。BCVA 中位数从基线时的-1.1（LogMAR），在贝伐单抗治疗结束时改善至-0.66，在末次随访时仍保持-0.63（P=0.047）。停止使用贝伐单抗后，一只眼的 KNV 进展。无眼部或全身并发症。
PROSE 中局部使用贝伐单抗治疗 KNV 有效，可改善视力。长期随访显示持久的疗效，无并发症。
