CAJ | 학술논문

目的观察玻璃体腔内注射Bevacizumab(Avastin)治疗湿性年龄相关性黄斑变性(ARMD)术后各时间段的视野变化情况.方法采用单中心随机临床研究方法.收集经间接眼底镜、荧光素眼底血管造影(FFA)以及光学相干断层扫描(OCT)检查确诊存在黄斑中心凹下脉络膜新生血管(CNV)的ARMD患者13例(15只眼),患眼最佳矫正视力均>0.1.患眼行Bevacizumab玻璃体腔内注射1.25mg(0.05ml),注射次数为6次,间隔6周至3个月,治疗后随访3～12个月,记录并分析术前及术后6周,3月,6月,12月的平均视觉敏感度(mean visual sensitivity,MS),平均缺损(mean defect,MD),缺损变异度(lose variance,Lv)的变化.结果以0周注射为基准,第24周及48周MS值与注射前MS值相比有显著性差异(t值分别为2.91、3.69,P值均<0.05));第48周MD值与注射前MD值(7.97±3.97)dB差异有统计学意义(t值为1.35,P<0.05);各组LV值与注射前LV值比较差异无统计学意义.结论多次玻璃体腔内注射Bevacizumab有利于改善湿性ARMD患者黄斑区视功能,主要体现在对视网膜平均敏感度以及平均缺损的改善上;重复4-6次注射后绝大多数湿性ARMD患者的视功能得到改善.
목적 관찰파리체강내주사Bevacizumab(Avastin)치료습성년령상관성황반변성(ARMD)술후각시간단적시야변화정황.방법 채용단중심수궤림상연구방법.수집경간접안저경、형광소안저혈관조영(FFA)이급광학상간단층소묘(OCT)검사학진존재황반중심요하맥락막신생혈관(CNV)적ARMD환자13례(15지안),환안최가교정시력균>0.1.환안행Bevacizumab파리체강내주사1.25mg(0.05ml),주사차수위6차,간격6주지3개월,치료후수방3～12개월,기록병분석술전급술후6주,3월,6월,12월적평균시각민감도(mean visual sensitivity,MS),평균결손(mean defect,MD),결손변이도(lose variance,Lv)적변화.결과 이0주주사위기준,제24주급48주MS치여주사전MS치상비유현저성차이(t치분별위2.91、3.69,P치균<0.05));제48주MD치여주사전MD치(7.97±3.97)dB차이유통계학의의(t치위1.35,P<0.05);각조LV치여주사전LV치비교차이무통계학의의.결론 다차파리체강내주사Bevacizumab유리우개선습성ARMD환자황반구시공능,주요체현재대시망막평균민감도이급평균결손적개선상;중복4-6차주사후절대다수습성ARMD환자적시공능득도개선.
Objective To evaluate visual field changes every time after systemic bevacizumab (Avastin) therapy in patients with choroidal neovascularization (CNV) related age-related macular degeneration (ARMD). Methods Single-center, uncontrolled clinical study. Thirteen CNV related ARMD patients (15 eyes) with best-corrected visual acuity (BCVA) more than 0.1 were determined by indirect ophthalmoscope, fundus fluorescein angiography (FFA) and optic coherence tomography (OCT). All these eyes were underwent 6 times intravitreal injections of bevacizumab (1.25mg, 0.05ml) at 6 w to 12 w intervals. The follow-up investigation time was from 3 to 12 months. Record and analyze the mean visual sensitivity (MS), mean defect (MD) and loss variance (LV) changes before and 6w, 12w. 24w, 48w after injections. Results Take 0 week as a baseline, we found MS values of 24th week and 48th week revealing a remarkable increase (t values were 2.91, 3.69 respectively, P<0.05). MD values at 48th week decreased when compared with that at 0 week (t value was 1.35, P <0. 05). There were no statistically significant differences when compared LV values within these groups. Conclusions Repeatedly intravitreal injections of bevacizumab are benefit for visual acuity of neovascular ARMD, especially changes in MS and MD values of macular retina. Visual acuity would improve in most of the neovascularization ARMD after 4-6 times injections.