Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration
Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration
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DOI：
10.1016/j.ophtha.2005.11.019
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发表时间：
2006-03-01
期刊：
影响因子：
13.7
通讯作者：
Giust, MJ
中科院分区：
文献类型：
--
作者：
Avery, RL;Pieramici, DJ;Giust, MJ
目的：报道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（AMD）患者的短期安全性、生物学效应和可能的作用机制。设计：干预性、连续性、回顾性病例系列。参与者：79例黄斑中心凹下新生血管性AMD患者的81只眼。方法：患者每月接受玻璃体内贝伐珠单抗（1.25 mg）治疗，直至黄斑水肿、视网膜下液（SRF）和/或色素上皮脱离（PED）消退。眼科评估包括非标准化Snellen视力（VA），完整的眼科检查，荧光素血管造影，光学相干断层扫描（OCT）。主要结果Measures：评估的安全性，Snellen VA，OCT视网膜厚度的变化，血管造影病变的特点进行了performed.Results：没有显着的眼部或全身副作用观察。大多数患者（55%）在注射后1周时具有> 10%的基线视网膜厚度减少。在注射后4周，81只眼中有30只显示视网膜水肿、SRF和PED完全消退。在随访8周的51只眼中，25只眼的视网膜增厚、SRF和PED完全消退。在第1、4、8和12周，中心1 mm的平均视网膜厚度分别减少61、92、89和67 μ m（第1、4和8周P < 0.0001，第12周P < 0.01）。在第4周和第8周，平均VA从20/200改善到20/125（P < 0.0001）。4周时中位视力从20/200提高到20/80（-），8周时从20/200提高到20/80。短期结果表明玻璃体内注射贝伐单抗（1.25 mg）耐受性良好，并且与VA改善、OCT视网膜厚度降低以及大多数患者血管造影渗漏减少相关，他们中的大多数人以前接受过光动力疗法和/或哌加他尼的治疗。进一步评价玻璃体内注射贝伐单抗治疗脉络膜新生血管是必要的。
Purpose: To report the short-term safety, biologic effect, and a possible mechanism of action of intravitreal bevacizumab in patients with neovascular age-related macular degeneration (AMD).Design: Interventional, consecutive, retrospective case series.Participants: Eighty-one eyes of 79 patients with subfoveal neovascular AMD.Methods: Patients received intravitreal bevacizumab (1.25 mg) on a monthly basis until macular edema, subretinal fluid (SRF), and/or pigment epithelial detachment (PED) resolved. Ophthalmic evaluations included nonstandardized Snellen visual acuity (VA), complete ophthalmic examination, fluorescein angiography, and optical coherence tomography (OCT).Main Outcome Measures: Assessments of safety, changes in Snellen VA, OCT retinal thickness, and angiographic lesion characteristics were performed.Results: No significant ocular or systemic side effects were observed. Most patients (55%) had a reduction of > 10% of baseline retinal thickness at 1 week after the injection. At 4 weeks after injection, 30 of 81 eyes demonstrated complete resolution of retinal edema, SRF, and PEDs. Of the 51 eyes with 8 weeks' follow-up, 25 had complete resolution of retinal thickening, SRF, and PEDs. At 1, 4, 8,and 12 weeks, the mean retinal thickness of the central 1 mm was decreased by 61, 92, 89, and 67 mu m, respectively (P < 0.0001 for 1, 4, and 8 weeks and P < 0.01 for 12 weeks). At 4 and 8 weeks, mean VA improved from 20/200 to 20/125 (P < 0.0001). Median vision improved from 20/200 to 20/80(-) at 4 weeks and from 20/200 to 20/80 at 8 weeks.Conclusions: Short-term results suggest that intravitreal bevacizumab (1.25 mg) is well tolerated and associated with improvement in VA, decreased retinal thickness by OCT, and reduction in angiographic leakage in most patients, the majority of whom had previous treatment with photodynamic therapy and/or pegaptanib. Further evaluation of intravitreal bevacizumab for the treatment of choroidal neovascularization is warranted.