玻璃体腔内注射Bevacizumab治疗年龄相关性黄斑变性

发布时间：2018-12-19 12:37

【摘要】：目的:评估抗血管内皮生长因子单克隆抗体bevacizumab(Avastin)玻璃体腔注射治疗湿性年龄相关性黄斑变性(age-related macular degeneration,AMD)的疗效和安全性。方法:对30例接受玻璃体腔注射bevacizumab(2.5mg)治疗的AMD患者进行回顾分析,主要评价指标包括最佳矫正视力(best-corrected visual acuity,BCVA)、黄斑中心凹厚度(central foveal thickness,CFT)和黄斑容积(total macularvolume,TMV),对注射后渗漏无明显改善或病情反复者进行眼内重复注射。所有病例都完成至少6mo的观察随访。结果:患者30例30眼中男21例,女9例,平均年龄72岁。治疗前患者的基线平均对数BCVA为1.03±0.55,CFT为364.97±151.83μm,TMV为8.36±1.84mm3,注药后1wk虽然平均CFT和TMV没有显著改善,但BCVA有显著提高(logMAR,0.79±0.33;P=0.002),经平均9.7mo的随访,BCVA(logMAR,0.70±0.40;P=0.004),CFT(272.93±81.06;P=0.005)和TMV(7.20±0.98;P=0.004)3项指标均较基线有显著改善,终末随访时BCVA提高至少两行者为18眼(60%),稳定者为8眼(27%)。本组患者共接受了58次玻璃体腔内注射,平均注射次数为1.93次/眼,有50%再注射能在术后1wk使视力提高两行或两行以上。结论:玻璃体腔注射bevacizumab能够安全有效地改善或稳定多数湿性AMD的病情,但术后定期随访以及根据病情变化进行再次注射是必要的。
[Abstract]:Aim: to evaluate the efficacy and safety of intravitreal injection of anti vascular endothelial growth factor monoclonal antibody (bevacizumab (Avastin) in the treatment of wet age related macular degeneration (age-related macular degeneration,AMD). Methods: 30 cases of AMD treated by intravitreal injection of bevacizumab (2.5mg) were retrospectively analyzed. The main evaluation parameters included best corrected visual acuity (best-corrected visual acuity,BCVA) and macular foveal thickness (central foveal thickness,). CFT) and macular volume (total macularvolume,TMV) were used for repeated intraocular injection in patients with no significant improvement of leakage or recurrence of the condition after injection. All patients completed at least 6mo observation and follow-up. Results: the average age of 30 patients was 72 years old. The baseline mean logarithmic BCVA was 1.03 卤0.55C T (364.97 卤151.83 渭 m). The mean 1wk was 8.36 卤1.84mm3.Although the mean CFT and TMV were not significantly improved, BCVA was significantly increased (logMAR,0.79 卤0.33). , BCVA (logMAR,0.70 卤0.40), CFT (272.93 卤81.06), CFT (and TMV (7.20 卤0.98) were followed-up with P0. 002 (P < 0. 002). At the end of follow-up, BCVA was increased in 18 eyes (60%) and 8 eyes (27%) at the end of follow-up. The patients received 58 intravitreal injections with an average of 1.93 times per eye. 50% of the patients could improve their visual acuity by two or more lines after 1wk. Conclusion: intravitreal injection of bevacizumab can improve or stabilize the condition of most wet AMD safely and effectively, but it is necessary to follow up regularly after operation and to re-inject according to the changes of the disease.
【作者单位】：青岛大学医学院附属烟台毓璜顶医院眼科;
【分类号】：R774.5

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