Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Ophthalmology, Meir Medical Center, Kfar Saba, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Curr Eye Res. 2021 Apr;46(4):539-545. doi: 10.1080/02713683.2020.1812085. Epub 2020 Aug 30.
To evaluate the anatomical correlation between fellow eyes for bilateral second-line anti-VEGF treatment in eyes with bilateral diabetic macular edema (DME) with incomplete response to first-line bevacizumab therapy.
Seventy-four eyes ( = 37 patients) with bilateral-DME having incomplete response to first-line bevacizumab therapy that were switched for bilateral treatment with ranibizumab were retrospectively evaluated. Data collected included demographics, visual acuity and macular thickness. We evaluate the correlation for the response of both eyes in terms of macular thickness and visual acuity.
The mean±SD age was 76 ± 8 years. The mean±SD number of bevacizumab injections prior the switch was 11.03 ± 5.1 in the first eye (FE) and 10.9 ± 5.2 in the second eye (SE). The central subfield thickness (CST) reduced from 472 ± 171 microns at baseline to 418 ± 161 after the last bevacizumab injection and 365 ± 74 after 3 ranibizumab injections in the FE ( = .016, = .004, respectively), and from 463 ± 145 microns to 446 ± 123, and 421 ± 103 in the SE ( = .112, = .001, respectively). There was strong positive correlation between the eyes for the CST reduction under bevacizumab and ranibizumab treatments in each visit. BCVA± SD at baseline was 0.41 ± 0.30 LogMAR in the FE, and 0.42 ± 0.29 in the SE ( = .44). After 3 injections of bevacizumab, the BCVA was 0.37 ± 0.26 and 0.42 ± 0.23 in FE and SE respectively ( = .013, = .132, respectively).
This study demonstrated a strong anatomical correlation responses between the eyes in patients with bilateral DME for both first-line bevacizumab therapy and second-line ranibizumab therapy. Response to second-line therapy was favorable and correlated among eyes regardless they were from the same or different individuals.
评估双侧糖尿病性黄斑水肿（DME）患者二线抗 VEGF 治疗中双侧眼之间的解剖相关性，这些患者对一线贝伐珠单抗治疗不完全反应。
回顾性评估了 74 只眼（=37 例）的资料，这些眼均患有双侧 DME，且对一线贝伐珠单抗治疗不完全反应，已转为双侧雷珠单抗治疗。收集的数据包括人口统计学、视力和黄斑厚度。我们评估了双眼在黄斑厚度和视力方面的反应相关性。
平均年龄为 76±8 岁。切换前第一只眼（FE）和第二只眼（SE）贝伐珠单抗注射的平均±SD 次数分别为 11.03±5.1 和 10.9±5.2。中央视网膜厚度（CST）从基线时的 472±171 微米降至最后一次贝伐珠单抗注射后的 418±161 微米和 FE 中 3 次雷珠单抗注射后的 365±74 微米（分别为=0.016，=0.004），而从 463±145 微米降至 446±123 微米和 SE 中的 421±103 微米（分别为=0.112，=0.001）。在每次就诊时，FE 和 SE 中 CST 减少与贝伐珠单抗和雷珠单抗治疗之间均存在强烈的正相关关系。FE 中基线时的 BCVA±SD 为 0.41±0.30 LogMAR，SE 中为 0.42±0.29（=0.44）。贝伐珠单抗注射 3 次后，FE 和 SE 中的 BCVA 分别为 0.37±0.26 和 0.42±0.23（分别为=0.013，=0.132）。
本研究表明，双侧 DME 患者的一线贝伐珠单抗治疗和二线雷珠单抗治疗中，双眼之间存在强烈的解剖相关性。二线治疗的反应良好，且无论双眼来自同一患者还是不同患者，均存在相关性。
