Effect of intravitreal bevacizumab on iris vessels in neovascular glaucoma patients
Effect of intravitreal bevacizumab on iris vessels in neovascular glaucoma patients
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DOI：
10.1007/s00417-010-1406-x
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发表时间：
2010-11-01
影响因子：
2.7
通讯作者：
Kiuchi, Yoshiaki
中科院分区：
文献类型：
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作者：
Sugimoto, Yosuke;Mochizuki, Hideki;Kiuchi, Yoshiaki
我们的目的是研究玻璃体内单次注射 1 mg 贝伐珠单抗对新生血管性青光眼 (NVG) 患者虹膜血管的影响。在小梁切除术中获得了 22 例青光眼患者的手术切除虹膜。 8 例来自青光眼手术前接受 1 mg 玻璃体内注射贝伐单抗 (IVB) 的 NVG 患者，8 例来自原发性开角型青光眼 (POAG) 患者，6 例来自未接受 IVB 注射的 NVG 患者。收集的虹膜标本经抗CD34单克隆抗体和抗VEGF单克隆抗体免疫组化染色后进行比较，比较三组标本中CD34阳性和VEGF阳性区域占标本总面积的百分比。各组间CD34阳性面积差异有统计学意义（p = 0.0061，Kruskal-Wallis检验）。 NVG 联合 IVB 组和 POAG 组之间的 CD34 阳性面积没有显着差异（p = 0.3017，采用 Bonferroni 校正的 Mann-Whitney U 检验）。 POAG 组的 CD34 阳性区域明显少于无 IVB 组的 NVG（p = 0.0019，采用 Bonferroni 校正的 Mann-Whitney U 检验）。许多血管保留在虹膜基质中，并且有 IVB 的 NVG 和无 IVB 的 NVG 组之间 CD34 阳性面积没有显着差异（p = 0.0357，采用 Bonferroni 校正的 Mann-Whitney U 检验）。不使用IVB的NVG组虹膜表面CD34表达的长度比显着长于使用IVB的NVG组（p = 0.0002，Mann-Whitney U检验）。所有组之间 VEGF 表达的差异具有统计学意义（p = 0.04，Kruskal-Wallis 检验）。有 IVB 组的 NVG 和无 IVB 组的 NVG 之间没有显着差异（p = 0.7963 Mann-Whitney U 检验，采用 Bonferroni 校正）。两组NVG组术后1天前房积血和纤维蛋白形成的频率无统计学意义。红斑性青光眼眼单次玻璃体内注射IVB 1 mg/0.04 ml可减少人虹膜表面的新生血管，但不能完全消除虹膜基质的新生血管。这一发现意味着，即使单剂 IVB 似乎消除了虹膜表面的新生血管，也无法预测基于裂隙灯检查的前房积血和纤维蛋白形成的预防。
We aimed to investigate the effects of a single 1-mg injection of intravitreal bevacizumab on iris vessels in neovascular glaucoma (NVG) patients.Twenty-two surgically resected irises from glaucoma patients were obtained during trabeculectomy. Eight were from patients with NVG who received a 1-mg injection of intravitreal bevacizumab (IVB) before glaucoma surgery, eight were from patients with primary open-angle glaucoma (POAG), and six were from patients with NVG who were not administered IVB. The collected iris specimens were compared after immunohistochemical staining with anti-CD34 monoclonal antibodies and anti-VEGF monoclonal antibody, and the percentage of CD34-positive and VEGF-positive regions in the total area of the specimens from the three groups was compared.The difference in the CD34-positive area between all groups was statistically significant (p = 0.0061, Kruskal-Wallis test). There was no significant difference in the CD34-positive area between the NVG with IVB group and the POAG group (p = 0.3017, Mann-Whitney U test with Bonferroni correction). The POAG group had significantly fewer CD34-positive regions than the NVG without IVB group (p = 0.0019, Mann-Whitney U test with Bonferroni correction). Many vessels remained in the iris stroma, and there was no significant difference in the CD34-positive area between the NVG with IVB and NVG without IVB groups (p = 0.0357, Mann-Whitney U test with Bonferroni correction). The ratio of the length of CD34 expression on the iris surface in the NVG without IVB group was significantly longer than that in the NVG with IVB group (p = 0.0002, Mann-Whitney U test). The difference in VEGF expression between all groups was statistically significant (p = 0.04, Kruskal-Wallis test). There was no significant difference between the NVG with IVB group and the NVG without IVB group (p = 0.7963 Mann-Whitney U test with Bonferroni correction). The frequency of hyphema and fibrin formation in the anterior chamber 1 day after surgery between the two NVG groups was not statistically significant.A single intravitreal dose of IVB at 1 mg/0.04 ml to eyes with rubeotic glaucoma reduced the neovascularization in the human iris surface, but could not eliminate completely neovascularization in iris stroma. This finding implies that the prevention of hyphema and fibrin formation based on the slit-lamp examination can not be predicted, even if neovascularization in iris surface seems to be eliminated by a single dose of IVB.