Visual and morphological outcomes of bevacizumab (AvastinA®) versus ranibizumab (LucentisA®) treatment for retinal angiomatous proliferation
Visual and morphological outcomes of bevacizumab (AvastinA®) versus ranibizumab (LucentisA®) treatment for retinal angiomatous proliferation
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DOI：
10.1007/s10792-012-9562-0
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发表时间：
2012-06-01
影响因子：
1.6
通讯作者：
Gamulescu, Maria-Andreea
中科院分区：
文献类型：
--
作者：
Hufendiek, Katerina;Hufendiek, Karsten;Gamulescu, Maria-Andreea
视网膜血管瘤样增生（RAP）是渗出性年龄相关性黄斑变性的一种变异，预后特别差。这项工作的目的是描述玻璃体内贝伐单抗和雷珠单抗治疗患者的长期功能和形态学结果。16只眼接受贝伐单抗治疗，19只眼接受雷珠单抗治疗的回顾性病例系列。所有患者最初每4周接受3次贝伐单抗（1.25 mg/0.05 ml）或雷珠单抗（0.5 mg/0.05 ml）玻璃体内注射。第三次注射后随访1至7个月。完整的眼科检查，包括最佳矫正视力（VA），光学相干断层扫描，荧光素血管造影，并在选定的情况下，吲哚菁绿色血管造影进行。三次玻璃体内注射导致贝伐珠单抗治疗患者和雷珠单抗治疗患者的VA改善;治疗前最小分辨角（logMAR）的对数为0.84，第9个月为0.67，治疗前logMAR为0.75，第9个月为0.59。贝伐单抗组的中心黄斑厚度（CMT）从基线时的363.67 +/- A 47.4 μ m改善到第6个月时的328 +/- A 49.77 μ m（p = 0.03）和第9个月时的301 +/- A 129.69（p = 0.35）。雷珠单抗组的CMT从基线时的545.62 +/- A 167.39 μ m改善至第6个月时的395.88 +/- A 169.37 μ m和第9个月时的411.83 +/- A 212.41 μ m（分别为p = 0.03，p = 0.05）。RAP患者可能受益于玻璃体内贝伐单抗和雷珠单抗治疗，在较长时间内稳定VA。然而，密切的后续行动，应在这个特殊的亚组，因为高复发率。
Retinal angiomatous proliferation (RAP) is a variant of exudative age-related macular degeneration with particularly bad prognosis. The purpose of this work is to describe the long-term functional and morphological outcome of patients treated with intravitreal bevacizumab and ranibizumab. Retrospective case series of 16 eyes treated with bevacizumab and 19 eyes treated with ranibizumab. All patients received initially three intravitreal injections of bevacizumab (1.25 mg/0.05 ml) or ranibizumab (0.5 mg/0.05 ml) every 4 weeks. Follow-up ranged from 1 to 7 months after the third injection. Complete ophthalmologic examination including best-corrected visual acuity (VA), optical coherence tomography, fluorescein angiography, and in selected cases, indocyanine green angiography was performed. Triple intravitreal injections resulted in improvement of VA in bevacizumab-treated as well as in ranibizumab-treated patients; logarithm of the minimal angle of resolution (logMAR) 0.84 before treatment and 0.67 at month 9, and logMAR 0.75 before treatment and 0.59 at month 9, respectively. Central macular thickness (CMT) in the bevacizumab group improved from 363.67 +/- A 47.4 mu m at baseline to 328 +/- A 49.77 mu m at month 6 (p = 0.03) and 301 +/- A 129.69 at month 9 (p = 0.35). CMT in the ranibizumab group improved from 545.62 +/- A 167.39 mu m at baseline to 395.88 +/- A 169.37 mu m at month 6 and 411.83 +/- A 212.41 mu m at month 9 (p = 0.03, p = 0.05, respectively). Patients with RAP might benefit from both intravitreal bevacizumab and ranibizumab treatments with stabilization of VA over a longer period of time. Close follow-up should nevertheless be performed in this special subgroup because of the high recurrence rate.