Efficacy and safety of one intravitreal injection of bevacizumab in diabetic macular oedema
Efficacy and safety of one intravitreal injection of bevacizumab in diabetic macular oedema
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DOI：
10.1111/j.1755-3768.2008.01254.x
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发表时间：
2008-11-01
影响因子：
3.4
通讯作者：
Tano, Yasuo
中科院分区：
文献类型：
--
作者：
Fang, Xiaoyun;Sakaguchi, Hirokazu;Tano, Yasuo
目的：评价贝伐单抗一次玻璃体内注射治疗糖尿病性黄斑水肿（DMO）的疗效、持续时间和安全性。方法：将贝伐单抗（1 mg/0.04 ml）玻璃体腔内注射至DMO患者（既往治疗29例，既往未治疗9例）。测量最佳矫正视力（BCVA）、眼压、视网膜中央厚度（CRT）；注射前、注射后2 ~ 4周、8周、12周分别行裂隙灯检查、黄斑生物显微镜检查、光学相干断层扫描和荧光素血管造影检查。分析两组最佳校正后的VA和CRT。结果：未预处理组在注射后2-4周和8周的平均BCVA分别从0.76 +/- 0.33（基线）改善到0.57 +/- 0.30和0.54 +/- 0.27 （p = 0.02, p = 0.014，配对t检验）。同一时间点的平均CRT分别从基线的632.4 +/- 196.0 mu m下降到392.3 +/- 113.6 mu m和370.4 +/- 141.7 mu m （p = 0.01, p = 0.01）。12周时BCVA和CRT无差异。注射后2-4周，预处理组平均BCVA从0.62 +/- 0.30（基线）改善至0.53 +/- 0.33 (p = 0.01)，注射后2-4周，平均CRT从583.9 +/- 180.7 μ m（基线）降至404.1 +/- 197.9 μ m （p < 0.001）。注射后8周和12周的平均BCVA不变，但8周时的平均CRT仍较低（p = 0.004）。随访期间未出现眼部或全身副作用。结论：一次玻璃体内注射贝伐单抗治疗DMO似乎对以前治疗过的眼睛和没有治疗过的眼睛都有效和安全。治疗效果是暂时的，可能需要重复治疗。
Purpose: To assess the efficacy, duration of effect and safety of one intravitreal injection of bevacizumab in diabetic macular oedema (DMO).Methods: Bevacizumab (1 mg/0.04 ml) was injected intravitreally into eyes with DMO (29 with and nine without previous treatments). Best corrected visual acuity (BCVA), intraocular pressure and central retinal thickness (CRT) were measured; slit-lamp examination, macular biomicroscopy, optical coherence tomography and fluorescein angiography were performed before and at 2-4, 8 and 12 weeks post-injection. Best corrected VA and CRT were analysed in both groups.Results: In the non-pretreated group, mean BCVA improved from 0.76 +/- 0.33 (baseline) to 0.57 +/- 0.30 and 0.54 +/- 0.27 at 2-4 weeks and 8 weeks post-injection, respectively (p = 0.02, p = 0.014, paired t-test). Mean CRT decreased from 632.4 +/- 196.0 mu m (baseline) to 392.3 +/- 113.6 mu m and 370.4 +/- 141.7 mu m at the same time-points, respectively (p = 0.01, p = 0.01). There was no difference in BCVA or CRT at 12 weeks. In the pretreated group, mean BCVA improved from 0.62 +/- 0.30 (baseline) to 0.53 +/- 0.33 at 2-4 weeks post-injection (p = 0.01), and mean CRT decreased from 583.9 +/- 180.7 mu m (baseline) to 404.1 +/- 197.9 mu m at 2-4 weeks post-injection (p < 0.001). Mean BCVA was unchanged at 8 weeks and 12 weeks post-injection, although mean CRT remained lower at 8 weeks (p = 0.004). No ocular or systemic side-effects developed during follow-up.Conclusions: One intravitreal injection of bevacizumab for DMO seems to be effective and safe in both eyes that have been treated previously and eyes that have not. The therapeutic effect is temporary and repeat treatment may be needed.