Kumagai Kazuyuki, Ogino Nobuchika, Fukami Marie, Furukawa Mariko
Kami-iida Daiichi General Hospital, Nagoya, Aichi, Japan,
Shinjo Ophthalmologic Institute, Miyazaki, Japan.
Clin Ophthalmol. 2019 Apr 11;13:617-626. doi: 10.2147/OPTH.S195600. eCollection 2019.
The purpose of this study was to determine the long-term outcomes of intravitreal bevacizumab (IVB) or intravitreal tissue plasminogen activator (tPA) or vitrectomy for macular edema associated with a branch retinal vein occlusion (BRVO).
This was a retrospective, interventional case series. Forty-one patients received a single 1.25 mg of IVB injection and followed by pro re nata protocol, 71 patients received a single intravitreal tPA, and 116 patients underwent phacovitrectomy with intraocular lens implantation.
The baseline characteristics and follow-up periods were not significantly different among the three groups. The mean follow-up period was 55.5 months with a range of 12-160 months. Sixteen patients (39.0%) in the IVB group, 24 patients (33.8%) in the tPA group, and two patients (1.7%) in the vitrectomy group underwent additional surgeries during the follow-up period. The best-corrected visual acuity (BCVA) significantly improved in all groups at 1 year after the initial treatment (all, <0.0001) and at the final visit (all, <0.0001). The differences in the BCVA between the three groups were not significant at all times after the initial treatment.
The three groups led to similar long-term good visual outcomes. However, additional surgeries were performed in more than 30% of patients in the IVB and tPA groups.
本研究旨在确定玻璃体内注射贝伐单抗（IVB）、玻璃体内注射组织纤溶酶原激活剂（tPA）或玻璃体切割术治疗视网膜分支静脉阻塞（BRVO）相关黄斑水肿的长期疗效。
这是一项回顾性干预病例系列研究。41例患者接受单次1.25mg的IVB注射，随后按需治疗，71例患者接受单次玻璃体内注射tPA，116例患者接受晶状体植入的晶状体玻璃体切除术。
三组患者的基线特征和随访时间无显著差异。平均随访时间为55.5个月，范围为12 - 160个月。IVB组16例患者（39.0%）、tPA组24例患者（33.8%）和玻璃体切割术组2例患者（1.7%）在随访期间接受了额外手术。初始治疗后1年时（所有组，<0.0001）和末次随访时（所有组，<0.0001），所有组的最佳矫正视力（BCVA）均显著改善。初始治疗后各时间点，三组之间的BCVA差异均无统计学意义。
三组均取得了相似的长期良好视力预后。然而，IVB组和tPA组超过30%的患者接受了额外手术。
