CAJ | 학술논문

目的采用玻璃体腔注射贝伐单抗治疗新生血管性青光眼,评价其对虹膜新生血管(NVI)消退和眼压控制的作用.方法采用回顾性研究.对22例(22只眼)新生血管性青光眼(NVG),行玻璃体腔内注射贝伐单抗(IVB) 2.5 mg/0.1 ml.对伴有虹膜前粘连的NVG患者,除了进行IVB,同时还进行复合式小梁切除术.进行上述操作后的患眼,都尽可能早地进行全视网膜光凝术(PRP).所有患者随访12个月.随访内容包括:NVI消退程度、眼压控制情况、视力提高程度和滤过性手术成功与否.结果进行IVB后的第2个月,所有患眼的NVI消退；第4个月,6例(27.3％)再次出现NVI,而第8个月时16例(72.7％) NVI复发.平均IOP从(42.93±5.61) mm Hg分别下降到(19.93±3.83) mm Hg(第6个月)和(16.72±1.91) mm Hg(第12个月).复合式小梁切除术成功率达70％.19例(86.4％)患眼视力提高,分别从术前的(0.10±0.08)提高到术后的(0.15±0.12).结论 IVB治疗NVG患者,对NVI消退和眼压控制起到一定作用,同时提高复合式小梁切除术的成功率；但这一作用具有时间局限性,需要反复进行IVB以维持疗效.
목적 채용파리체강주사패벌단항치료신생혈관성청광안,평개기대홍막신생혈관(NVI)소퇴화안압공제적작용.방법 채용회고성연구.대22례(22지안)신생혈관성청광안(NVG),행파리체강내주사패벌단항(IVB) 2.5 mg/0.1 ml.대반유홍막전점련적NVG환자,제료진행IVB,동시환진행복합식소량절제술.진행상술조작후적환안,도진가능조지진행전시망막광응술(PRP).소유환자수방12개월.수방내용포괄:NVI소퇴정도、안압공제정황、시력제고정도화려과성수술성공여부.결과 진행IVB후적제2개월,소유환안적NVI소퇴；제4개월,6례(27.3％)재차출현NVI,이제8개월시16례(72.7％) NVI복발.평균IOP종(42.93±5.61) mm Hg분별하강도(19.93±3.83) mm Hg(제6개월)화(16.72±1.91) mm Hg(제12개월).복합식소량절제술성공솔체70％.19례(86.4％)환안시력제고,분별종술전적(0.10±0.08)제고도술후적(0.15±0.12).결론 IVB치료NVG환자,대NVI소퇴화안압공제기도일정작용,동시제고복합식소량절제술적성공솔；단저일작용구유시간국한성,수요반복진행IVB이유지료효.
Objective To demonstrate the role of intravitreal bevacizumab in regression of iris neovascularization,and intraocular pressure (IOP) control in neovascular glaucoma.Methods A retrospective random case series study was performed.Twenty-two eyes of 22 patients who presented with neovascular glaucoma were treated with intravitreal bevacizumab 2.5mg in 0.1ml.Subscleral trabeculectomy was performed for cases having peripheral anterior synechiae.Panretinal photocoagulation (PRP) was carried out for all cases as soon as possible after intravitreal injection.Cases were followed up for 12 months when regression of iris neovessels,IOP control,improvement in visual acuity,and success of filtering surgery were recorded.Results All cases showed complete regression of iris neovessels at 2 months after injection,recurrence of iris neovessels was observed in 6cases (27.3％) at 4 months and in 16 cases (72.7％) at 8 months follow-up.The mean IOP dropped from (42.93±5.61) mmHg preoperatively to (19.93±3.83) mmHg and (16.72±1.91) mmHg at 6months and 12 months postoperatively,respectively.The success rate of subscleral trabeculectomy after intravitreal bevacizumab was 70％.Visual acuity was improved in 19 cases (86.4％) from preoperative (0.10±0.09) to (0.16±0.12) postoperative.Conclusions Intravitreal bevacizumab has a role in regression of iris neovessels and IOP control in neovascular glaucoma cases and also in increasing the success rate of subscleral tra-beculectomy,however this role has a limited time and reinjection is needed to maintain this effect.