目的：评价玻璃体腔内注射 bevacizumab(贝伐珠单抗)治疗视网膜静脉阻塞(retinal vein occlusion,RVO)的临床效果与安全性。<br> 方法：对50例56眼接受玻璃体腔注射 bevacizumab (1.75mg)治疗的视网膜静脉阻塞患者进行回顾性分析,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)等方法,观察治疗后1,2,3,6mo 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)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6mo的观察随访。玻璃体腔内注射 bevacizumab 1.75mg,每6wk 注射一次。<br> 结果：患者50例56眼平均年龄57±18.56岁。患者48眼视力和黄斑水肿得到改善,治疗前患者的基线平均对数BCVA 为 logMAR0.82±0.63,CFT 为626.5±178.0μm,注药后1wk 虽然平均 CFT 没有显著改善,但 BCVA 有显著提高,经平均10.26±5.87mo 的随访,BCVA,CFT 均较基线有显著改善,CFT 的统计结果显示,患者治疗后1,2,3mo 黄斑中心视网膜厚度均较治疗前存在显著性差异,即黄斑中心视网膜厚度较治疗前明显变薄,黄斑水肿明显改善。RVO 所致黄斑水肿(ME)患者治疗后1,3,12mo CFT 分别为365.11±23.212,333.42±35.526,267.6±116.8μm,相比较有显著性差异( P<0.01),CRVO-ME 和 BRVO-ME在治疗前后各时间点的 CFT 之间比较无统计学差异(P>0.05)。 OCT 图像显示治疗后黄斑视网膜厚度明显变薄。FFA 显示治疗后黄斑区荧光素渗漏明显减少,即黄斑水肿明显消退。终末随访时患者 BCVA 提高至少两行者为48眼(86%),稳定者为8眼(14%)。本组患者共接受了112次玻璃体腔内注射,平均注射次数为1.96次/眼,有50%再注射能在术后1wk 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。<br> 结论：玻璃体腔内注射 bevacizumab 可改善视网膜静脉阻塞(CRVO,BRVO)继发黄斑水肿患者的视功能(VA),减轻黄斑水肿,减少 CNV 渗漏,且重复治疗效果更佳。但长期治疗效果需要进一步观察。本研究中未发现与药物有关的严重的眼部及全身不良反应。
目的：評價玻璃體腔內註射 bevacizumab(貝伐珠單抗)治療視網膜靜脈阻塞(retinal vein occlusion,RVO)的臨床效果與安全性。<br> 方法：對50例56眼接受玻璃體腔註射 bevacizumab (1.75mg)治療的視網膜靜脈阻塞患者進行迴顧性分析,通過常規眼科檢查方法、光學相榦斷層掃描(OCT)、眼底熒光血管造影(FFA)等方法,觀察治療後1,2,3,6mo 最佳矯正視力(best corrected visual acuity,BCVA)、眼壓、晶狀體、玻璃體、黃斑中心凹厚度(central foveal thickness,CFT)變化,與治療前對比分析。對註射後滲漏無明顯改善或病情反複者進行眼內重複註射,所有病例都完成至少6mo的觀察隨訪。玻璃體腔內註射 bevacizumab 1.75mg,每6wk 註射一次。<br> 結果：患者50例56眼平均年齡57±18.56歲。患者48眼視力和黃斑水腫得到改善,治療前患者的基線平均對數BCVA 為 logMAR0.82±0.63,CFT 為626.5±178.0μm,註藥後1wk 雖然平均 CFT 沒有顯著改善,但 BCVA 有顯著提高,經平均10.26±5.87mo 的隨訪,BCVA,CFT 均較基線有顯著改善,CFT 的統計結果顯示,患者治療後1,2,3mo 黃斑中心視網膜厚度均較治療前存在顯著性差異,即黃斑中心視網膜厚度較治療前明顯變薄,黃斑水腫明顯改善。RVO 所緻黃斑水腫(ME)患者治療後1,3,12mo CFT 分彆為365.11±23.212,333.42±35.526,267.6±116.8μm,相比較有顯著性差異( P<0.01),CRVO-ME 和 BRVO-ME在治療前後各時間點的 CFT 之間比較無統計學差異(P>0.05)。 OCT 圖像顯示治療後黃斑視網膜厚度明顯變薄。FFA 顯示治療後黃斑區熒光素滲漏明顯減少,即黃斑水腫明顯消退。終末隨訪時患者 BCVA 提高至少兩行者為48眼(86%),穩定者為8眼(14%)。本組患者共接受瞭112次玻璃體腔內註射,平均註射次數為1.96次/眼,有50%再註射能在術後1wk 使視力提高兩行或兩行以上。治療過程中未髮現嚴重不良反應。<br> 結論：玻璃體腔內註射 bevacizumab 可改善視網膜靜脈阻塞(CRVO,BRVO)繼髮黃斑水腫患者的視功能(VA),減輕黃斑水腫,減少 CNV 滲漏,且重複治療效果更佳。但長期治療效果需要進一步觀察。本研究中未髮現與藥物有關的嚴重的眼部及全身不良反應。
목적：평개파리체강내주사 bevacizumab(패벌주단항)치료시망막정맥조새(retinal vein occlusion,RVO)적림상효과여안전성。<br> 방법：대50례56안접수파리체강주사 bevacizumab (1.75mg)치료적시망막정맥조새환자진행회고성분석,통과상규안과검사방법、광학상간단층소묘(OCT)、안저형광혈관조영(FFA)등방법,관찰치료후1,2,3,6mo 최가교정시력(best corrected visual acuity,BCVA)、안압、정상체、파리체、황반중심요후도(central foveal thickness,CFT)변화,여치료전대비분석。대주사후삼루무명현개선혹병정반복자진행안내중복주사,소유병례도완성지소6mo적관찰수방。파리체강내주사 bevacizumab 1.75mg,매6wk 주사일차。<br> 결과：환자50례56안평균년령57±18.56세。환자48안시력화황반수종득도개선,치료전환자적기선평균대수BCVA 위 logMAR0.82±0.63,CFT 위626.5±178.0μm,주약후1wk 수연평균 CFT 몰유현저개선,단 BCVA 유현저제고,경평균10.26±5.87mo 적수방,BCVA,CFT 균교기선유현저개선,CFT 적통계결과현시,환자치료후1,2,3mo 황반중심시망막후도균교치료전존재현저성차이,즉황반중심시망막후도교치료전명현변박,황반수종명현개선。RVO 소치황반수종(ME)환자치료후1,3,12mo CFT 분별위365.11±23.212,333.42±35.526,267.6±116.8μm,상비교유현저성차이( P<0.01),CRVO-ME 화 BRVO-ME재치료전후각시간점적 CFT 지간비교무통계학차이(P>0.05)。 OCT 도상현시치료후황반시망막후도명현변박。FFA 현시치료후황반구형광소삼루명현감소,즉황반수종명현소퇴。종말수방시환자 BCVA 제고지소량행자위48안(86%),은정자위8안(14%)。본조환자공접수료112차파리체강내주사,평균주사차수위1.96차/안,유50%재주사능재술후1wk 사시력제고량행혹량행이상。치료과정중미발현엄중불량반응。<br> 결론：파리체강내주사 bevacizumab 가개선시망막정맥조새(CRVO,BRVO)계발황반수종환자적시공능(VA),감경황반수종,감소 CNV 삼루,차중복치료효과경가。단장기치료효과수요진일보관찰。본연구중미발현여약물유관적엄중적안부급전신불량반응。
To evaluate the safety and efficacy of intravitreal bevacizumab injection in patients with macular edema (ME) induced by retinal vein occlusion (RVO). <br> ● METHODS: The records of patients treated with intravitreal injection of 1. 75mg bevacizumab for ME induced by RVO were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography ( OCT) and fundus fluorescein angiography ( FFA ), etc. Best corrected visual acuity (BCVA), intraocular pressure, the change of lens and vitreous, central foveal thickness (CFT) were observed at 1, 2, 3, 6mo after treatment and compared with before treatment. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. All the cases were followed up at least 6mo. An intravitreal injection of bevacizumab (1. 75mg) was given at 6wk intervals. <br> ●RESULTS: Fifty patients (56 eyes) with the average of (57±18. 56) years old were included. The mean baseline of BCVA, CFT were (logMAR0. 82±0. 63), (626. 5±178. 0)μm respectively. Although there was no significant decrease in mean CFT at 1wk after injection, the mean BCVA had significant improvement. Followed up at mean 10. 26 ± 5. 87mo, BCVA, CFT showed significant improvements over baseline values. The statistics of CFT at 1, 2, 3mo after injection were significant differences compared with before injection in each of the three groups. CFT at 1, 3, 12mo after injection were (365. 11±23. 212) μ m, (333. 42± 35. 526) μ m, (267. 6 ± 116. 8) μ m, which had a significant difference ( P < 0. 001), namely macular retinal thickness was thinner obviously that before treatment, ME was improved obviously. CFT was no significant difference at each time point after injection in the group of BRVO-ME and CRVO- ME (P> 0. 05). OCT image showed that after injection macular retinal thickness was becoming thinner. FFA showed that after injection macular fluorescein leakage decreased. BCVA was improved by at least two lines in 48 eyes (86%),remained stable in 8 eyes (14%) at the last visit. A total of 112 injections were performed and the average number of injections was 1. 96 in the group. About 50% of reinjections gained at least two lines of vision improvement at 1wk following the retreatment. There was no serious complications during the treatment. <br> ●CONCLUSlON: lntravitreal injection of bevacizumab can improve visual acuity (VA) of RVO (CRVO and BRVO) in patients with ME, relieve ME, reduce the leakage of CNV, and repeated treatment is better. But a prolonged treatment effect needs further observation. There are no serious ocular and systemic complications occurred in our study.
