RANDOMIZED CONTROLLED STUDY OF INTRAVITREAL BEVACIZUMAB 0.16 MG INJECTED ONE DAY BEFORE SURGERY FOR PROLIFERATIVE DIABETIC RETINOPATHY
RANDOMIZED CONTROLLED STUDY OF INTRAVITREAL BEVACIZUMAB 0.16 MG INJECTED ONE DAY BEFORE SURGERY FOR PROLIFERATIVE DIABETIC RETINOPATHY
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DOI：
10.1097/iae.0000000000000577
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发表时间：
2015-09-01
影响因子：
3.3
通讯作者：
Yuzawa, Mitsuko
中科院分区：
文献类型：
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作者：
Manabe, Ayumu;Shimada, Hiroyuki;Yuzawa, Mitsuko
目的：探讨玻璃体手术前1d玻璃体内注射贝伐单抗（Bevacizumab，IVB）0.16mg/0.05mL对增殖性糖尿病视网膜病变（proliferative diabetic retinopathy，PDR）的疗效。方法：将62例（66眼）有玻璃体手术指征的增殖性糖尿病视网膜病变患者随机分为IVB组（34眼）和假手术对照组（32眼）。玻璃体内注射贝伐珠单抗组于玻璃体切除术前1 d玻璃体内注射贝伐珠单抗0.16 mg/0.05 mL，假手术对照组于玻璃体切除术前1 d玻璃体内注射假手术。结果：IVB组术后4周内因复发性玻璃体积血再次手术的发生率（3.1%，1/32）明显低于假手术组（20.6%，7/34）（P = 0.033）。IVB组的术中血管内热点数量（0.63 ± 1.0 vs. 1.3 ± 1.4，P = 0.025）和术后复发性玻璃体积血的频率（3.1%，1/32 vs. 23.5%，8/34，P = 0.017）显著低于假手术对照组。结论：玻璃体切割术前1d玻璃体内注射贝伐珠单抗0.16mg/0.05mL可阻断玻璃体内血管内皮生长因子的生成，显著降低术后早期复发性玻璃体积血再手术的发生率。
Purpose:To investigate the usefulness of 0.16 mg/0.05 mL intravitreal bevacizumab (IVB) injection 1 day before vitrectomy for proliferative diabetic retinopathy.Methods:Sixty-two patients with proliferative diabetic retinopathy (66 eyes) with an indication for primary vitrectomy were randomized to IVB group (34 eyes) or sham control group (32 eyes). Intravitreal bevacizumab group received intravitreal injection of 0.16 mg/0.05 mL bevacizumab, and sham control group received sham injection 1 day before vitrectomy. Vitreous fluid was sampled before vitrectomy was started.Results:Frequency of reoperation due to recurrent vitreous hemorrhage within 4 weeks after surgery was significantly lower (P = 0.033) in IVB group (3.1%, 1/32) than in sham control group (20.6%, 7/34). The number of intraoperative endodiathermy spots (0.63 +/- 1.0 vs. 1.3 +/- 1.4, P = 0.025) and frequency of postoperative recurrent vitreous hemorrhage (3.1%, 1/32 vs. 23.5%, 8/34, P = 0.017) were significantly lower in IVB group than in sham control group. Vitreous vascular endothelial growth factor concentrations were 1315.3 +/- 1153.4 pg/mL in sham control group and 25.0 +/- 13.6 pg/mL in IVB group (P < 0.0001).Conclusion:Intravitreal injection of 0.16 mg/0.05 mL bevacizumab 1 day before vitrectomy blocked vascular endothelial growth factor production in vitreous and significantly reduced the incidence of reoperation due to early postoperative recurrent vitreous hemorrhage.