Long-term Results of Intravitreal Bevacizumab Injection for Choroidal Neovascularization Secondary to Angioid Streaks
Long-term Results of Intravitreal Bevacizumab Injection for Choroidal Neovascularization Secondary to Angioid Streaks
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DOI：
10.1016/j.ajo.2009.04.026
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发表时间：
2009-10-01
影响因子：
4.2
通讯作者：
Tano, Yasuo
中科院分区：
文献类型：
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作者：
Sawa, Miki;Gomi, Fumi;Tano, Yasuo
目的：探讨玻璃体腔内注射贝伐单抗（Avastin; Genentech Inc, South San Francisco, California， USA）治疗血管样条纹继发脉络膜新生血管（CNV）的长期疗效。设计：观察性病例系列。方法：13例患者15只眼（5男8女，平均年龄59岁，年龄范围54 ~ 70岁）接受1 mg玻璃体内贝伐单抗注射。首次注射后最少随访12个月。之前接受过治疗的眼睛被排除在外。测量最佳矫正视力（BCVA）。在治疗前后检查光学相干断层扫描和荧光素血管造影图像。结果：平均随访19个月（12 ~ 24个月）。原发性CNV平均注射次数为4.5次（范围1 ~ 9）。术前平均BCVA（十进制当量）在最后一次访问时为0.39（范围0.08至1.5）和0.47（范围0.06至1.2）（P = .355）。5眼（33%）复诊时BCVA改善最小分辨角对数2行，8眼（54%）不变，2眼（1.3%）下降。最终的荧光素血管造影检查显示10只眼（67%）无渗漏，2只眼（13%）有轻微渗漏，3只眼（20%）持续或反复渗漏。5只眼（33%）在最后一次贝伐单抗注射后4至7个月（平均5.1个月）复发。在最后一次注射贝伐单抗治疗原发性CNV后6至14个月，3只眼睛（20%）的不同区域出现新的CNV病变。结论：玻璃体内注射贝伐单抗似乎可以维持视力。然而，在长时间的随访中，CNV经常复发或出现新的CNV。[J]中华眼科杂志，2009;48(4):584- 589。(C) 2009年Elsevier Inc.版权所有。)
PURPOSE: To investigate the long-term efficacy of intravitreal injections of bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) for choroidal neovascularization (CNV) secondary to angioid streaks.DESIGN: Observational case series.METHODS: Fifteen eyes of 13 patients (5 men, 8 women; mean age, 59 years; range, 54 to 70 years) treated with 1-mg intravitreal bevacizumab injections were included. The minimum follow-up after the first injection was 12 months. Eyes that had undergone previous treatments were excluded. The best,corrected visual acuity (BCVA) was measured. Optical coherence tomography and fluorescein angiography images were examined before and after treatment.RESULTS: The mean follow-up was 19 months (ranged 12 to 24 months). The mean number of injections for primary CNV was 4.5 (range, 1 to 9). The mean preoperative BCVA (decimal equivalent) was 0.39 (range, 0.08 to 1.5) and 0.47 (range, 0.06 to 1.2) at the final visit (P = .355). The BCVA improved by 2 lines of logarithm of the minimum angle of resolution visual acuity at the final visit in 5 eyes (33%), was unchanged in 8 eyes (54%), and decreased in 2 eyes (1.3%). The final fluorescein angiography examination showed no leakage in 10 eyes (67%), minimal leakage in 2 eyes (13%), and persistent or recurrent leakage in 3 eyes (20%). Five eyes (33%) had a recurrence 4 to 7 months (mean, 5.1 months) after the last bevacizumab injection. New CNV lesions developed in different areas in 3 eyes (20%) 6 to 14 months after the last bevacizumab injection for primary CNV.CONCLUSIONS: An intravitreal injection of bevacizumab seems to maintain visual acuity. However, CNV frequently recurred or new CNV developed during the long follow-up. (Am J Ophthalmol 2009;148:584-590. (C) 2009 by Elsevier Inc. All rights reserved.)