Comparison of Visual Outcome and Regression Pattern of Myopic Choroidal Neovascularization After Intravitreal Bevacizumab or After Photodynamic Therapy
Comparison of Visual Outcome and Regression Pattern of Myopic Choroidal Neovascularization After Intravitreal Bevacizumab or After Photodynamic Therapy
复制标题
DOI：
10.1016/j.ajo.2009.03.026
复制
发表时间：
2009-09-01
影响因子：
4.2
通讯作者：
Mochizuki, Manabu
中科院分区：
文献类型：
--
作者：
Hayashi, Kengo;Ohno-Matsui, Kyoko;Mochizuki, Manabu
目的：比较接受玻璃体内贝伐单抗 (IVB) 治疗的脉络膜新生血管 (CNV) 近视眼与接受光动力疗法 (PDT) 治疗的近视眼的 1 年视觉和解剖结果。设计：开放标签、连续、介入性病例系列。方法：接受 PDT 治疗的 42 名连续近视 CNV 患者的 44 只眼睛，以及 43 名连续近视患者的 43 只眼睛对用 IVB 治疗的 CNV 进行了评估。作为对照，对 71 名未经治疗的连续近视 CNV 患者的 74 只眼睛进行了评估。在 12 个月的随访期间，使用协方差分析 (ANCOVA) 对 26 名未经事先治疗的 IVB 治疗患者、35 名未经事先治疗的 PDT 治疗患者和 71 名未经治疗的对照者进行最佳矫正视力 (BCVA) 的比较。 结果：39 只接受 IVB 治疗的眼睛 (91%) 进行了血管造影闭合，21 只 (48.8%) 的视力改善。 I 年 BCVA 中>2 条线。 1 年时，IVB 治疗患者的 BCVA 明显优于 PDT 治疗和对照眼睛。在成功治疗的 IVB 眼中，CNV 大小在 12 个月的随访期间持续减小，而在成功治疗的 PDT 眼中，65% 的 CNV 大小没有减小，甚至增大。 PDT 治疗的眼睛发生脉络膜视网膜萎缩的频率明显高于 IVB 治疗的眼睛。结论：IVB 对近视 CNV 比 PDT 更有效。 CNV 回归模式和脉络膜视网膜萎缩率的差异可能解释了 IVB 治疗眼的最佳最佳矫正视力 (BCVA)。 （美国眼科杂志 2009 年；148：396-408。(C) 2009 年，Elsevier Inc. 保留所有权利。）
PURPOSE: To compare the 1-year visual and anatomic outcomes in myopic eyes with choroidal neovascularization (CNV) treated by intravitreal bevacizumab (IVB) to those treated by photodynamic therapy (PDT).DESIGN: An open-label, consecutive, interventional case series.METHODS: Forty-four eyes of 42 consecutive patients with myopic CNV treated with PDT, and 43 eyes of 43 consecutive patients with myopic CNV treated with IVB, were evaluated. For control, 74 eyes of 71 consecutive patients with untreated myopic CNV were evaluated. The comparison of best-corrected visual acuity (BCVA) using analysis of covariance (ANCOVA) during the 12-month follow-up period was performed among the 26 IVB-treated patients without prior treatment, 35 PDT-treated patients without prior treatment, and 71 nontreated controls.RESULTS: Thirty-nine of the IVB-treated eyes (91%) had angiographic closure, and 21 (48.8%) had an improvement of >2 lines in the BCVA at I year. IVB-treated patients had significantly better BCVA than PDT-treated and control eyes at 1 year. The CNV size continued to decrease during the 12-month follow-up in the successfully treated IVB eyes, and the size did not decrease, or even increased, in 65% of the successfully treated PDT eyes. Chorioretinal atrophy developed Significantly more frequently in PDT-treated than IVB-treated eyes.CONCLUSIONS: IVB is more effective for myopic CNV than PDT. The differences in the regression pattern of CNVs and the rate of chorioretinal atrophy probably explain the better BCVA in the IVB treated eyes. (Am J Ophthalmol 2009;148:396-408. (C) 2009 by Elsevier Inc. All rights reserved.)