Intravitreal Bevacizumab Treatment for Choroidal Neovascularization in Pathologic Myopia: 12-month Results
Intravitreal Bevacizumab Treatment for Choroidal Neovascularization in Pathologic Myopia: 12-month Results
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DOI：
10.1016/j.ajo.2008.07.022
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发表时间：
2009-01-01
影响因子：
4.2
通讯作者：
Gabrieli, Corrado Balacco
中科院分区：
文献类型：
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作者：
Gharbiya, Magda;Allievi, Francesca;Gabrieli, Corrado Balacco
目得：评价玻璃体内注射hevacizumab治疗近视性脉络膜新生血管（CNV）的短期疗效和安全性。设计：前瞻性、非随机、干预性病例系列。方法：来自20例继发于病理性近视的CNV患者的20只眼参与了这项前瞻性非随机干预性病例系列。所有患者均计划接受3个月的玻璃体内贝伐珠单抗1.25 mg注射。早期治疗糖尿病视网膜病变研究最好的，矫正视力（BCVA），中心凹厚度（FCT）的光学相干断层扫描（OCT），和荧光素血管造影结果进行了检查之前和之后的治疗。结果：基线时的平均BCVA（+/-标准差[SDI]）为24.8（+/- 11.86）个字母（Snellen当量：20/80）。治疗后12个月，平均BCVA（+/- SD）显著改善（P = .000001）至43（+/- 12.38）个字母（Snellen等效值：20/35）。在12个月随访时，20只治疗眼中有18只（90%）BCVA改善10个字母或更多，20只治疗眼中有14只（70%）BCVA改善15个字母或更多。治疗眼均未发生BCVA较基线恶化。基线时的平均FCT（+/- SD）为223（+/- 47.43）微米。治疗后12个月，平均FCT（+/- SD）降至206（+/- 50.87）微米。治疗后FCT的降低无统计学意义（P = 0.11）。在12个月随访时，20只治疗眼中有19只（95%）显示CNV无荧光素渗漏，1只（5%）显示持续渗漏。在12个月随访时，19只CNV闭合眼均未复发。治疗未出现眼部或全身不良反应。结论：玻璃体内注射贝伐单抗治疗近视性CNV的结果是非常有希望的，没有明显的短期安全性问题。12个月时，治疗眼的视力（VA）显著改善。OCT结果也显示出与观察到的VA有益变化一致的趋势。治疗导致95%的患眼完全无血管造影渗漏。需要进一步研究以更好地确定长期疗效和安全性。(Am J Ophthalmol 2009;147：84-93. (c)2009年，Elsevier Inc.版权所有© 2016
PURPOSE: To evaluate the short-term efficacy and safety of intravitreal hevacizumab for the treatment of myopic choroidal neovascularization (CNV).DESIGN: Prospective, nonrandomized, interventional case series. 0METHODS: Twenty eyes from 20 patients with CNV secondary to pathologic myopia participated in this prospective nonrandomized interventional case series. All patients were scheduled for three monthly intravitreal bevacizumab 1.25 mg injections. Early Treatment Diabetic Retinopathy Study best,corrected visual acuity (BCVA), foveal center thickness (FCT) on optical coherence tomography (OCT), and fluorescein angiographic findings were examined before and after treatment. Patients were followed up for 12 months.RESULTS: The mean BCVA (+/- standard deviation [SDI]) at baseline was 24.8 (+/- 11.86) letters (Snellen equivalent: 20/80). At 12 months after treatment, the mean BCVA (+/- SD) improved significantly (P = .000001) to 43 (+/- 12.38) letters (Snellen equivalent: 20/35). At 12 month follow,up, BCVA improved 10 letters or more in 18 (90%) out of 20 treated eyes and improved 15 letters or more in 14 (70%) out of 20 treated eyes. No treated eyes experienced a worsening of BCVA from baseline. The mean FCT(+/- SD) at baseline was 223 (+/- 47.43) microns. At 12 months after treatment, the mean FCT (+/- SD) reduced to 206 (+/- 50.87) microns. This reduction in FCT after treatment was not statistically significant (P = .11). At 12 months follow-up, absence of fluorescein leakage from the CNV was demonstrated in 19 (95%) out of 20 treated eyes and persistent leakage in one eye (5%). None of the 19 eyes that had CNV closure experienced recurrence at 12-month follow-up. No ocular or systemic adverse effects from treatment were encountered. 0CONCLUSION: These results of intravitreal bevacizumab in myopic CNV are very promising with no apparent short-term safety concerns. At 12 months, treated eyes had a significant improvement in visual acuity (VA). OCT findings, as well, showed a trend consistent with the beneficial changes observed for VA. Treatment resulted in complete absence of angiographic leakage in 95% of eyes. Further studies will be needed to better determine long term efficacy and safety. (Am J Ophthalmol 2009;147:84-93. (c) 2009 by Elsevier Inc. All rights reserved.)