Wang Nancy, Hunt Adrian, Nguyen Vuong, Shah Janika, Fraser-Bell Samantha, McAllister Ian, Barthelmes Daniel, Gillies Mark, Squirrell David
Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
University of Sydney, Sydney Medical School, Discipline of Ophthalmology and Eye Health, Save Sight Institute, New South Wales, Australia.
Clin Exp Ophthalmol. 2022 Dec;50(9):1038-1046. doi: 10.1111/ceo.14139. Epub 2022 Aug 4.
Bevacizumab is the only agent that many people can afford, yet there are only limited data on whether it improves macular oedema (MO) secondary to retinal vein occlusion (RVO) in real-world clinical practice. Here we studied 12-month real-world treatment outcomes of bevacizumab for RVO-related MO.
This was a multicentre, observational study analysing 12-month data from the Fight Retinal Blindness! (FRB) database. We studied treatment-naïve eyes with MO secondary to RVO commencing bevacizumab therapy between June 2009 and June 2019. Visual acuity (VA) and central subfield thickness (CST) were measured at baseline, 6 and 12 months. The primary outcome was a change in VA from baseline to 12 months.
Two hundred and twenty treatment naive eyes were analyzed. The baseline VA for BRVO was better than CRVO (55.8 vs. 42.6 LogMAR letters) and this gap widened over the 12-month period, with a 12-month VA change of +14.0 (95% CI 11.1, 16.8) letters for BRVO and + 11.9 (95% CI 6.4, 17.4) for CRVO. The mean CST at baseline was 511 μm for BRVO and 627 μm for CRVO, falling at 12 months by -155 μm (-190, -121) in BRVO and -198 μm (-252, -145) in CRVO. The median number of injections for BRVO and CRVO completers was 7 (5, 9).
Bevacizumab can be an effective treatment of RVO-MO in a real-world setting with outcomes approaching those reported by the seminal clinical trials. The functional and anatomical outcomes of intravitreal therapy were better for BRVO than CRVO.
贝伐单抗是许多人都能负担得起的唯一药物，但在实际临床实践中，关于其是否能改善视网膜静脉阻塞（RVO）继发的黄斑水肿（MO）的数据有限。在此，我们研究了贝伐单抗治疗RVO相关MO的12个月真实世界治疗效果。
这是一项多中心观察性研究，分析了来自“抗击视网膜失明！”（FRB）数据库的12个月数据。我们研究了2009年6月至2019年6月期间开始接受贝伐单抗治疗的初治RVO继发MO的眼睛。在基线、6个月和12个月时测量视力（VA）和中心子野厚度（CST）。主要结局是从基线到12个月时VA的变化。
分析了220只初治眼睛。BRVO的基线VA优于CRVO（55.8对42.6 LogMAR字母），且在12个月期间这一差距扩大，BRVO的12个月VA变化为+14.0（95%CI 11.1, 16.8）字母，CRVO为+11.9（95%CI 6.4, 17.4）字母。BRVO基线时的平均CST为511μm，CRVO为627μm，12个月时BRVO下降了-155μm（-190, -121），CRVO下降了-198μm（-252, -145）。BRVO和CRVO完成治疗者的注射次数中位数为7次（5, 9）。
在真实世界环境中，贝伐单抗可以有效治疗RVO-MO，其效果接近开创性临床试验报告的结果。玻璃体内注射治疗对BRVO的功能和解剖学结局优于CRVO。
