目的:评估抗血管内皮生长因子单克隆抗体Bevacizumab(Avastin)玻璃体腔注射治疗特发性脉络膜新生血管病变(idiopathic choroidal neovascularization,ICNV)的疗效和安全性。方法:对40例接受玻璃体腔注射Bevacizumab(2.5mg)治疗的ICNV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)。对注射后1mo症状无改善或病情反复者并经眼底荧光素血管造影(fundusfluorescein angiography,FFA)和/或光学相干断层扫描(opticalcoherence tomography,OCT)证实者进行眼内重复注射。结果:所有40例40眼患者均完成至少6mo的随访,其中男19例,女21例,平均年龄33.0±6.8岁。治疗前患者的基线平均对数BCVA为0.66±0.35,CFT为275.39±107.59μm。注药后1mo平均对数BCVA为0.30±0.29(P=0.000),CFT为185.39±45.77μm(P=0.000);本组患者经平均9.2mo的随访,平均对数BCVA提高至0.31±0.38(P=0.000),CFT降至192.38±55.52μm(P=0.000),均较基线水平有显著改善。终末随访时符合视力提高者为27眼(67.5%),稳定者8眼(20.0%)。本组患者共接受了52次玻璃体腔内注射,平均注射次数为1.30次/眼,有63.6%患者在再注射术后1mo视力提高两行或两行以上。结论:玻璃体腔注射Bevacizumab能够快速有效地改善或稳定多数ICNV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)in patients with idiopathic choroidal neovascularization (ICNV). METHODS:The records of patients treated with intravitreal injection of 2.5mg Bevacizumab for ICNV were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography (OCT) 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) over at least 6 months were the main outcome measures. RESULTS:Forty eyes of 40 patients (19 males and 21 females) with the average age of 33.0±6.8 were included. The mean baseline of BCVA and CFT were 0.66±0.35(logMAR) and 275.39±107.59μm, respectively. One month after injection, the mean BCVA (logMAR 0.30±0.29,P=0.000) and CFT (185.39±45.77μm, P=0.000) were significantly improved. At the last visit of 9.2 months follow up, both BCVA (logMAR 0.31±0.38,P=0.000) and CFT (192.38±55.52μm,P=0.000) showed significant improvements over baseline values. BCVA was improved by at least two lines in 27 eyes (67.5%), remained stable in 8 eyes(20.0%)at the last visit. A total of 52 injections were performed and the average number of injections was 1.30/eye in the group. About 63.6% of re-injections gained at least two lines of vision improvement one month following the re-treatment. No serious ocular or systemic adverse events were observed. CONCLUSION:Intravitreal injection of bevacizumab for ICNV was well tolerated with an improvement in BCVA, CFT over the mean 9.2 months follow-up period. Re-injection of intravitreal bevacizumab should be administered when needed.

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