目的:评估抗血管内皮生长因子单克隆抗体bevacizumab(Avastin)玻璃体腔注射治疗湿性年龄相关性黄斑变性(age-related macular degeneration,AMD)的疗效和安全性。方法:对30例接受玻璃体腔注射bevacizumab(2.5mg)治疗的AMD患者进行回顾分析,主要评价指标包括最佳矫正视力(best-corrected visual acuity,BCVA)、黄斑中心凹厚度(central foveal thickness,CFT)和黄斑容积(total macularvolume,TMV),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。结果:患者30例30眼中男21例,女9例,平均年龄72岁。治疗前患者的基线平均对数BCVA为1.03±0.55,CFT为364.97±151.83μm,TMV为8.36±1.84mm3,注药后1wk虽然平均CFT和TMV没有显著改善,但BCVA有显著提高(logMAR,0.79±0.33;P=0.002),经平均9.7mo的随访,BCVA(logMAR,0.70±0.40;P=0.004),CFT(272.93±81.06;P=0.005)和TMV(7.20±0.98;P=0.004)3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18眼(60%),稳定者为8眼(27%)。本组患者共接受了58次玻璃体腔内注射,平均注射次数为1.93次/眼,有50%再注射能在术后1wk使视力提高两行或两行以上。结论:玻璃体腔注射bevacizumab能够安全有效地改善或稳定多数湿性AMD的病情,但术后定期随访以及根据病情变化进行再次注射是必要的。

·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 2.5mg bevacizumab for AMD were retrospectively reviewed.All patients were evaluated by complete ophthalmic examination,optical coherence tomography and fluorescein and/or indocyanine green angiography.Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation.Changes in best-corrected visual acuity(BCVA),central foveal thickness(CFT)and total macular volume(TMV)over at least 6 months were the main outcome measures.·RESULTS:Thirty eyes of 30 patients(21 males and 9 females)with the average of 72 years old were included.The mean baseline of BCVA,CFT and TMV were 1.03±0.55(logMAR),364.97±151.83μm and 8.36±1.84mm3,respectively.Although there was no significant decrease in mean CFT and TMV one week after the injection,the mean BCVA had significant improvement(logMAR,0.79±0.33;P=0.02).At the last visit of 9.7 months follow-up(data available for 30 eyes),BCVA(logMAR,0.70±0.40;P=0.004),CRT(272.93±81.06;P=0.05)and TMV(7.20±0.98;P=0.004)showed significant improve-ments over baseline values.BCVA was improved by at least two lines in 18 eyes(60%),remained stable in 8 eyes(27%)at the last visit.A total of 58 injections were performed and the average number of injections was 1.93 in the group.About 50% of re-injections gained at least two lines of vision improvement one week following the re-treatment.No serious ocular or systemic adverse events were observed.·CONCLUSION:Intravitreal injection of bevacizumab for exudative AMD was well tolerated with an improvement in BCVA,CFT and TMV over the mean 9.7 months follow-up period.Re-injection of intravitreal bevacizumab should be administered if needed.·

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