中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2015年
3期
252-255
,共4页
视网膜毛细血管扩张症/治疗%血管生成抑制剂/治疗应用%抗体,单克隆/治疗应用
視網膜毛細血管擴張癥/治療%血管生成抑製劑/治療應用%抗體,單剋隆/治療應用
시망막모세혈관확장증/치료%혈관생성억제제/치료응용%항체,단극륭/치료응용
Retinal telangiectasis/therapy%Angiogenesis inhibitors/therapeutic use%Antibodies,monoclonal/therapeutic use
目的 观察玻璃体腔注射抗血管内皮生长因子(VEGF)药物联合其他方法治疗晚期Coats病的临床疗效.方法 回顾性病例系列研究.经眼底和荧光素眼底血管造影(FFA)检查确诊为晚期Coats病的14例患者14只眼纳入研究.其中,3B期8只眼,4期6只眼.所有患眼行视力、眼压、间接检眼镜、裂隙灯显微镜、FFA、眼部B型超声检查.14只眼中,视力无光感3只眼,光感4只眼,手动3只眼,数指2只眼,因患儿年幼无法配合检查2只眼.所有患眼均可见异常扩张视网膜血管及视网膜下大量胆固醇样结晶及渗出,伴全视网膜脱离.所有患眼均行玻璃体腔注射贝伐单抗或雷珠单抗治疗,注射次数为1～7次,平均注射次数2.14次.14只眼中,联合单纯巩膜外放液4只眼,联合单纯激光光凝治疗2只眼,联合玻璃体切割、剥膜、冷冻、激光光凝、硅油填充等治疗8只眼.治疗后随访时间4～36个月,平均随访时间18.8个月.随访期间采用与治疗前相同的检查设备和方法行相关检查,观察患眼视力及视网膜复位情况.结果 随访期间,无1例患者因病情进展而行眼球摘除手术,眼球保留率100.0％.14只眼中,视力提高2只眼,视力稳定8只眼,视力下降2只眼,因年幼无法配合检查2只眼.所有患眼视网膜下液均有不同程度吸收.14只眼中,视网膜完全复位5只眼,占35.7％;视网膜基本复位3只眼,占21.4％;视网膜未复位6只眼,占42.8％.随访过程中发生并发性白内障2只眼,均为行玻璃体切割手术者.其余患眼均未发生全身及眼部不良反应.结论 玻璃体腔注射抗VEGF药物联合其他方法治疗晚期Coats病能稳定或提高大部分息眼视力,促进视网膜下液吸收.
目的 觀察玻璃體腔註射抗血管內皮生長因子(VEGF)藥物聯閤其他方法治療晚期Coats病的臨床療效.方法 迴顧性病例繫列研究.經眼底和熒光素眼底血管造影(FFA)檢查確診為晚期Coats病的14例患者14隻眼納入研究.其中,3B期8隻眼,4期6隻眼.所有患眼行視力、眼壓、間接檢眼鏡、裂隙燈顯微鏡、FFA、眼部B型超聲檢查.14隻眼中,視力無光感3隻眼,光感4隻眼,手動3隻眼,數指2隻眼,因患兒年幼無法配閤檢查2隻眼.所有患眼均可見異常擴張視網膜血管及視網膜下大量膽固醇樣結晶及滲齣,伴全視網膜脫離.所有患眼均行玻璃體腔註射貝伐單抗或雷珠單抗治療,註射次數為1～7次,平均註射次數2.14次.14隻眼中,聯閤單純鞏膜外放液4隻眼,聯閤單純激光光凝治療2隻眼,聯閤玻璃體切割、剝膜、冷凍、激光光凝、硅油填充等治療8隻眼.治療後隨訪時間4～36箇月,平均隨訪時間18.8箇月.隨訪期間採用與治療前相同的檢查設備和方法行相關檢查,觀察患眼視力及視網膜複位情況.結果 隨訪期間,無1例患者因病情進展而行眼毬摘除手術,眼毬保留率100.0％.14隻眼中,視力提高2隻眼,視力穩定8隻眼,視力下降2隻眼,因年幼無法配閤檢查2隻眼.所有患眼視網膜下液均有不同程度吸收.14隻眼中,視網膜完全複位5隻眼,佔35.7％;視網膜基本複位3隻眼,佔21.4％;視網膜未複位6隻眼,佔42.8％.隨訪過程中髮生併髮性白內障2隻眼,均為行玻璃體切割手術者.其餘患眼均未髮生全身及眼部不良反應.結論 玻璃體腔註射抗VEGF藥物聯閤其他方法治療晚期Coats病能穩定或提高大部分息眼視力,促進視網膜下液吸收.
목적 관찰파리체강주사항혈관내피생장인자(VEGF)약물연합기타방법치료만기Coats병적림상료효.방법 회고성병례계렬연구.경안저화형광소안저혈관조영(FFA)검사학진위만기Coats병적14례환자14지안납입연구.기중,3B기8지안,4기6지안.소유환안행시력、안압、간접검안경、렬극등현미경、FFA、안부B형초성검사.14지안중,시력무광감3지안,광감4지안,수동3지안,수지2지안,인환인년유무법배합검사2지안.소유환안균가견이상확장시망막혈관급시망막하대량담고순양결정급삼출,반전시망막탈리.소유환안균행파리체강주사패벌단항혹뢰주단항치료,주사차수위1～7차,평균주사차수2.14차.14지안중,연합단순공막외방액4지안,연합단순격광광응치료2지안,연합파리체절할、박막、냉동、격광광응、규유전충등치료8지안.치료후수방시간4～36개월,평균수방시간18.8개월.수방기간채용여치료전상동적검사설비화방법행상관검사,관찰환안시력급시망막복위정황.결과 수방기간,무1례환자인병정진전이행안구적제수술,안구보류솔100.0％.14지안중,시력제고2지안,시력은정8지안,시력하강2지안,인년유무법배합검사2지안.소유환안시망막하액균유불동정도흡수.14지안중,시망막완전복위5지안,점35.7％;시망막기본복위3지안,점21.4％;시망막미복위6지안,점42.8％.수방과정중발생병발성백내장2지안,균위행파리체절할수술자.기여환안균미발생전신급안부불량반응.결론 파리체강주사항VEGF약물연합기타방법치료만기Coats병능은정혹제고대부분식안시력,촉진시망막하액흡수.
Objective To observe the efficacy of adjuvant intravitreal injection of anti-vascular endothelial growth factor (VEGF) therapy for advanced Coats disease.Methods This study is a retrospective case series study.Fourteen patients (14 eyes),presenting Coats Stages 3B and 4 (8 and 6 eyes,respectively) were enrolled.All the patients were treated with adjuvant intravitreal anti-VEGF therapy.The intravitreal anti-VEGF injections varied from 1 to 7,with a median injections of 2.14.In 14 eyes,combined therapy was subretinal fluid drainage in 4 eyes,photocoagulation in 2 eyes,vitrectomy in 8 eyes.The follow-up period was ranged from 4 to 36 months,with a median follow-up of 18.8 months.Visual acuity and retinal reattachment were observed in follow up.Results At last follow up,global suvival was 100.0％ with no enucleation performed in any patient because of disease progression.Except for 2 children who were unable to cope with the visual acuity test,visual acuity was improved in 2 patients,stable in 8 patients,and decreased in 2 patients.5 patients (35.7％) achieved in complete retinal reattachment,3 patients (21.4％) were succeed in partial retinal reattachment,and the remain 6 patients(42.8％) failed in retinal reattachment.Two patients developed cataract after vitrectomy,and no other adverse reaction was observed during follow-up.Conclusion Anti-VEGF therapy combined with classic treatments in advanced Coats disease can keep or impove the visual acuity in most patients by reducing of subretinal exudation.
