Rizwan Amna, Asghar Asfandyar, Yasmeen Naila, Hasan Naqvi Syed Ali
Department of Ophthalmology, King Edward Medical University, Mayo Hospital, Lahore, Pakistan.
Department of Ophthalmology, Fauji Foundation Hospital, Rawalpindi, Pakistan.
J Pak Med Assoc. 2022 Nov;72(11):2213-2217. doi: 10.47391/JPMA.4729.
To assess the outcomes of intravitreal bevacizumab in patients of diabetic maculopathy by anatomical outcomes and best-corrected visual acuity, and to assess the prognostic factors that influence the efficacy of intravitreal bevacizumab.
The quasi-experimental study was conducted at the Department of Ophthalmology, Fauji Foundation Hospital, Rawalpindi, Pakistan, from January 2019 to January 2020, and comprised patients with diabetic maculopathy who were administered intravitreal bevacizumab on a monthly basis for three months with further injections administered on an as-needed basis in cases of persistent macular oedema or deterioration of best-corrected visual acuity. The assessment was done pre-injection, and three and six months after the injection. Outcome variables were best-corrected visual acuity and central macular thickness. Data was analysed using SPSS 22.
Of the 34 patients, 2(5.9%) were males and 32(94.1%) were females. The overall mean age was 58±10 years. Of the 55 eyes, 27(49.1%) were right and 28(50.9%) were left eyes. After 3 months, the best-corrected visual acuity improved by one line in 20(36.4%) eyes. At 6 months, it improved by one line in 25(45.4%) eyes. After 3 months, the central macular thickness of 48(87.2%) eyes improved anatomically. At 6 months, a further decrease in central macular thickness resulted in 50(90.9%) eyes. The best-corrected visual acuity at 6 months was inversely correlated with central macular thickness and disruption of inner segment/outer segment integrity.
Intravitreal bevacizumab injection led to appreciable improvement in best-corrected visual acuity and central macular thickness at 6 months. Disruption of inner segment/outer segment integrity, presence of exudates and cystic changes were noted that lead to poor visual prognosis.
通过解剖学结果和最佳矫正视力评估玻璃体内注射贝伐单抗治疗糖尿病性黄斑病变患者的疗效，并评估影响玻璃体内注射贝伐单抗疗效的预后因素。
这项准实验研究于2019年1月至2020年1月在巴基斯坦拉瓦尔品第法吉基金会医院眼科进行，纳入糖尿病性黄斑病变患者，每月玻璃体内注射贝伐单抗，共注射三个月，若持续性黄斑水肿或最佳矫正视力恶化则按需进一步注射。在注射前、注射后3个月和6个月进行评估。结果变量为最佳矫正视力和中心黄斑厚度。使用SPSS 22进行数据分析。
34例患者中，2例（5.9%）为男性，32例（94.1%）为女性。总体平均年龄为58±10岁。55只眼中，27只（49.1%）为右眼，28只（50.9%）为左眼。3个月后，20只（36.4%）眼的最佳矫正视力提高了一行。6个月时，25只（45.4%）眼的最佳矫正视力提高了一行。3个月后，48只（87.2%）眼的中心黄斑厚度在解剖学上有所改善。6个月时，50只（90.9%）眼的中心黄斑厚度进一步降低。6个月时的最佳矫正视力与中心黄斑厚度以及内节/外节完整性破坏呈负相关。
玻璃体内注射贝伐单抗在6个月时可使最佳矫正视力和中心黄斑厚度得到显著改善。观察到内节/外节完整性破坏、存在渗出物和囊性改变会导致视力预后不良。
