CAJ | 학술논문

目的：评价玻璃体腔内注射贝伐单抗(阿瓦斯汀)治疗老年性黄斑变性( age-related macular degeneration,AMD)的临床效果与安全性。 　　方法：对48例50眼接受玻璃体腔注射 bevacizumab (1-75mg)治疗的AMD患者进行回顾分析,通过常规眼科检查方法、光学相干断层扫描( OCT )、眼底荧光血管造影( FFA)和/或吲哚青绿血管造影( ICGA)等方法,观察治疗后1,3,7 d；1,6 mo 最佳矫正视力( best corrected visual acuity,BCVA)、眼压、晶状体、玻璃体、黄斑中心凹厚度( central foveal thickness, CFT )和黄斑容积( total macular volume,TMV)变化,与治疗前对比分析。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3 mo 的观察随访。玻璃体腔内注射 avastin 1-75mg,每6wk注射一次。 　　结果：在48例50眼患者中,平均年龄58±20.46岁。治疗前患者的基线平均对数 BCVA 为0.82±0.53, CFT 为364-97±151.83μm,注药后1wk虽然平均CFT和TMV没有显著改善,但BCVA有显著提高,经平均9.7 mo的随访, BCVA,CFT和TMV3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32眼(64%),稳定者为18眼(36%)。本组患者共接受了98次玻璃体腔内注射,平均注射次数为1.98次/眼,有50%患者再注射能在术后1 wk使视力提高两行或两行以上。治疗过程中未发现严重不良反应。 　　结论：玻璃体腔内注射bevacizumab治疗湿性AMD引起的CNV安全、副作用少,可改善患者的视功能( VA ),减轻黄斑水肿,减少 CNV 渗漏。但长期治疗效果需要进一步观察。
목적：평개파리체강내주사패벌단항(아와사정)치료노년성황반변성( age-related macular degeneration,AMD)적림상효과여안전성。 　　방법：대48례50안접수파리체강주사 bevacizumab (1-75mg)치료적AMD환자진행회고분석,통과상규안과검사방법、광학상간단층소묘( OCT )、안저형광혈관조영( FFA)화/혹신타청록혈관조영( ICGA)등방법,관찰치료후1,3,7 d；1,6 mo 최가교정시력( best corrected visual acuity,BCVA)、안압、정상체、파리체、황반중심요후도( central foveal thickness, CFT )화황반용적( total macular volume,TMV)변화,여치료전대비분석。대주사후삼루무명현개선혹병정반복자진행안내중복주사,소유병례도완성지소3 mo 적관찰수방。파리체강내주사 avastin 1-75mg,매6wk주사일차。 　　결과：재48례50안환자중,평균년령58±20.46세。치료전환자적기선평균대수 BCVA 위0.82±0.53, CFT 위364-97±151.83μm,주약후1wk수연평균CFT화TMV몰유현저개선,단BCVA유현저제고,경평균9.7 mo적수방, BCVA,CFT화TMV3항지표균교기선유현저개선,종말수방시BCVA제고지소량행자위32안(64%),은정자위18안(36%)。본조환자공접수료98차파리체강내주사,평균주사차수위1.98차/안,유50%환자재주사능재술후1 wk사시력제고량행혹량행이상。치료과정중미발현엄중불량반응。 　　결론：파리체강내주사bevacizumab치료습성AMD인기적CNV안전、부작용소,가개선환자적시공능( VA ),감경황반수종,감소 CNV 삼루。단장기치료효과수요진일보관찰。
AIM: To evaluate the safety and efficacy of intravitreal bevacizumab ( avastin ) injection in patients with exudative age related macular degeneration ( AMD) . METHODS: The records of patients treated with intravitreal injection of 1. 75mg bevacizumab for AMD were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography and fundus fluorescein and/or indocyanine green angiography. Observation was made on the best corrected visual acuity ( BCVA) , intraocular pressure, and the changes of lens, vitreous, central retinal thickness (CFT) and total macular volume (TMV), at 1d, 3d, 7d, 1mo and 6mo after the treatment and then compared with those of pre - operation. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. And all cases were followed up at least 6mo. An intravitreal injection of bevacizumab (1. 75mg) was given once every 6wk. RESULTS:All 50 eyes of 48 patients with the average of 58±20. 46 years old were included. The mean baseline of BCVA and CFT were 0. 82±0. 53, and 364. 97±151. 83μm respectively. Although there was no significant decrease in mean CFT and TMV one week after the injection, the mean BCVA had significant improvement. At the last visit of 9. 7mo follow - up, BCVA, CRT and TMV showed significant improvements over baseline values. BCVA was improved by at least two lines in 32 eyes (64%),remained stabilization in 18 eyes (36%) at the last visit. A total of 98 injections were performed and the average number of injections was 1. 98 for each eye in the group. About 50%of re - injections gained at least two lines of vision improvement one week postoperatively. There were no serious adverse events during the treatment. CONCLUSION: Intravitreal bevacizumab ( avastin ) injection for managing CNV due to age-related macular degeneration is safe and few side effects. Intravitreal avastin associated with improvement in visual acuity ( VA ) , which can reduce macular edema and choroidal neovascularization leakage. But a prolonged treatment effect needs further observation.