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玻璃体内注射贝伐单抗治疗新生血管性年龄相关性黄斑变性的形态和功能视网膜变化。

Morphological and functional retinal changes in neovascular age-related macular degeneration treated with intravitreal bevacizumab.

机构信息

Elite School of Optometry, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India.

Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation, Chennai, Tamil Nadu, India.

出版信息

Indian J Ophthalmol. 2022 Dec;70(12):4376-4382. doi: 10.4103/ijo.IJO_1184_22.

Abstract

PURPOSE

This study was conducted to determine the morphological and functional retinal changes in patients with neovascular age-related macular degeneration (nAMD) treated with intravitreal bevacizumab 1.25 mg.

METHODS

This was a prospective, nonrandomized, interventional study. Eighteen eyes of 18 subjects with nAMD were treated with intravitreal bevacizumab (1.25 mg) injection. Subjects underwent complete ophthalmic evaluation which included visual acuity, slitlamp examination, tonometry, binocular ophthalmoscopy, optical coherence tomography (OCT), and MP1 microperimetry before the intravitreal injection and the follow-up at 1 and 3 months. Test of significance such as Chi-squared test, paired ttest and oneway analysis of variance (ANOVA) linear trend were used to compare the pre- and post-anti-VEGF outcomes. Intraclass correlation was done to assess the intra observer variability.

RESULTS

Mean retinal sensitivity had increased from 3.77 ± 3.13 dB at baseline to 4.93 ± 2.42 dB at 3 months (P = 0.05). Visual acuity improved from 0.62 ± 0.36 at baseline to 0.52 ± 0.36 at 1 month and 0.48 ± 0.34 at 3-month followup, but overall change was not significant (P = 0.40). There was a significant reduction in central foveal thickness (CFT) from 274.61 ± 117.95 at baseline to 179.83 ± 84.18 at 1 month and 179.00 ± 126.55 at 3-month follow-up (P = 0.013).

CONCLUSION

Intravitreal bevacizumab (1.25 mg) injection in nAMD improves retinal function, quantified by retinal sensitivity, scotoma characteristics, fixation stability by MP 1 microperimetry and morphological parameters quantified by CFT in SDOCT. These changes show the effectiveness of treatment with intravitreal bevacizumab in nAMD.

摘要

目的

本研究旨在探讨玻璃体内注射 1.25mg 贝伐单抗治疗新生血管性年龄相关性黄斑变性(nAMD)患者的形态和功能视网膜变化。

方法

这是一项前瞻性、非随机、干预性研究。18 例 nAMD 患者的 18 只眼接受玻璃体内注射贝伐单抗(1.25mg)治疗。所有患者均接受全面眼科评估,包括视力、裂隙灯检查、眼压、双目检眼镜检查、光学相干断层扫描(OCT)和 MP1 微视野检查,在玻璃体内注射前和注射后 1 个月和 3 个月进行随访。采用卡方检验、配对 t 检验和单向方差分析(ANOVA)线性趋势检验比较抗 VEGF 治疗前后的结果。采用组内相关系数评估观察者内变异性。

结果

平均视网膜敏感性从基线时的 3.77 ± 3.13dB 增加到 3 个月时的 4.93 ± 2.42dB(P=0.05)。视力从基线时的 0.62 ± 0.36 提高到 1 个月时的 0.52 ± 0.36 和 3 个月时的 0.48 ± 0.34,但总体变化无统计学意义(P=0.40)。中央视网膜厚度(CFT)从基线时的 274.61 ± 117.95 减少到 1 个月时的 179.83 ± 84.18 和 3 个月时的 179.00 ± 126.55(P=0.013)。

结论

玻璃体内注射 1.25mg 贝伐单抗可改善 nAMD 患者的视网膜功能,通过 MP1 微视野评估的视网膜敏感性、黄斑区暗点特征、固视稳定性,以及通过 SDOCT 评估的 CFT 等形态学参数来量化。这些变化表明玻璃体内注射贝伐单抗治疗 nAMD 是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94a0/9940573/b9b0711d1d03/IJO-70-4376-g001.jpg

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