玻璃体内联合注射贝伐单抗和一种ROCK抑制剂（法舒地尔）治疗视网膜静脉阻塞继发的难治性黄斑水肿：一项初步研究。
Combined intravitreal injection of bevacizumab and a ROCK inhibitor (fasudil) for refractory macular edema secondary to retinal vein occlusion: a pilot study.
作者信息
Fekri Sahba, Nourinia Ramin, Rahimi-Ardabili Babak, Daneshtalab Arash, Sabbaghi Hamideh, Ahmadieh Hamid, Kheiri Bahareh
机构信息
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, No 23, Paidarfard St., Boostan 9 St., Pasdaran Ave, Tehran, 16666, Iran.
Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
出版信息
Int J Retina Vitreous. 2022 Jun 11;8(1):37. doi: 10.1186/s40942-022-00389-x.
BACKGROUND
To investigate the adjunctive effect of an intravitreal ROCK inhibitor (fasudil) in combination with intravitreal bevacizumab (IVB) on refractory macular edema secondary to retinal vein occlusion (RVO).
METHODS
In this prospective interventional case series, 17 eyes of 17 patients (10 men, 7 women) with refractory RVO-related macular edema underwent three consecutive intravitreal injections of bevacizumab plus fasudil. Monthly evaluation was continued up to 12 months and IVB injection was performed if needed during the follow-up. Changes in the best corrected visual acuity (BCVA) was the primary outcome measure. The secondary outcome measures included central macular thickness (CMT) changes and any adverse events.
RESULTS
BCVA significantly improved (mean change: -0.15 LogMAR; P = 0.017) after 3 consecutive intravitreal injections of fasudil in combination with bevacizumab. CMT significantly decreased (mean change: -206 µm; P = 0.028). The anatomical and functional improvement was maintained during the 12 month follow-up. No adverse effects were noticed.
CONCLUSION
Intravitreal ROCK inhibitors may break the resistance to anti-VEGF therapy and improve the RVO induced macular edema via affecting the VEGF-independent pathways.
背景
探讨玻璃体内注射ROCK抑制剂（法舒地尔）联合玻璃体内注射贝伐单抗（IVB）对视网膜静脉阻塞（RVO）继发的难治性黄斑水肿的辅助治疗效果。
方法
在这个前瞻性干预性病例系列研究中，17例（10例男性，7例女性）患有难治性RVO相关性黄斑水肿的患者的17只眼连续接受了3次玻璃体内注射贝伐单抗加用了法舒地尔。每月进行评估，持续12个月，随访期间必要时进行IVB注射。最佳矫正视力（BCVA）的变化是主要结局指标。次要结局指标包括中心黄斑厚度（CMT）变化和任何不良事件。
结果
连续3次玻璃体内注射法舒地尔联合贝伐单抗后，BCVA显著改善（平均变化：-0.15 LogMAR；P = 0.017）。CMT显著降低（平均变化：-206 µm；P = 0.028）。在12个月的随访期间，解剖学和功能改善得以维持。未观察到不良反应。
结论
玻璃体内注射ROCK抑制剂可能会打破对抗VEGF治疗的抵抗，并通过影响不依赖VEGF的途径改善RVO引起的黄斑水肿。
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