玻璃体腔注射贝伐单抗治疗慢性CSC的长期疗效观察
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国家自然科学基金面上项目资助(No.30973257)


Long-term effect of intravitreal bevacizumab injection for chronic central serous chorioretinopathy
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General Programs of National Natural Science Foundation of China(No. 30973257)

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    摘要:

    目的:探讨玻璃体腔注射贝伐单抗(IVB)治疗慢性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的安全性和长期临床疗效。

    方法:我们给予6例6眼慢性CSC患者玻璃体腔注射1.25mg/0.05mL IVB治疗。5例患者在第一次注射后3mo接受了第二次相同剂量的注射。注射后1,3,6,12,24mo时随访观察。观察指标包括治疗前后的最佳矫正视力、眼压、OCT、眼底荧光素造影(FFA)。

    结果:第一次玻璃体腔注射IVB后,2例患者视网膜下液(SRF)完全吸收,但其中1例在随访至3mo复发; 3例患者SRF有小幅度上升或下降; 1例患者的SRF先上升后明显下降; 再次进行IVB后,3例患者SRF完全吸收,其他的3例患者SRF无明显变化。但是SRF的吸收与视力的变化并不是同步的。治疗前后1,2a患者的视力变化在统计学上没有显著性差异。随访期间所有患者眼压均在正常范围,无一例出现眼内炎。

    结论:玻璃体腔注射IVB对于治疗慢性CSC患者是安全的,对促进SRF的吸收有一定效果,但从长期结果来看,IVB对于慢性CSC患者的远期视力预后无明显作用。

    Abstract:

    AIM: To evaluate the safety and long-term efficacy of intravitreal bevacizumab injection(IVB)as therapy for chronic central serous chorioretinopathy(CSC).

    METHODS: Six patients(6 eyes)with CSC were treated with an intravitreal injection of bevacizumab(1.25mg/0.05mL). 5 patients received second intravitreal injection of bevacizumab 3 months after the first injection. Patients had follow-up on 1, 3, 6, 12, 24 months after the injections. Outcome measures included pre and post-treatment changes in best-corrected visual acuity, intraocular pressure(IOP), subretinal fluid(SRF)measurement with optical coherence tomography(OCT), changes in fluorescein angiography(FA).

    RESULTS: After the first injection, 1 patient showed resolution of SRF completely, while his visual acuity showed no change; 1 patient whose visual acuity improved and SRF resolved completely on 1 month recurred; 3 patients showed no obvious changes in the SRF and in visual acuity; 1 patient showed decreased thickness of SRF while his visual acuity were stable. After the second injection, 1 patient showed resolution of SRF completely with improved his visual acuity; 2 patients showed resolution of SRF completely, while his visual acuity showed no change; the others showed no obvious change. The changes of SRF and visual acuity seemed to have no direct relation. The visual acuity showed no significant difference before and 12,24 months after the first injections. Pre and post-treatment the IOP of the 6 patients all belong to normal range. No cases of endophthalmitis were reported.

    CONCLUSION:IVB have some effect in chronic CSC cases in improving subretinal fluid resolution. But IVB have no long-term effect on improving visual acuity.

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陈曦,刘庆淮,刘肖艺.玻璃体腔注射贝伐单抗治疗慢性CSC的长期疗效观察.国际眼科杂志, 2012,12(12):2322-2325.

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  • 收稿日期:2012-10-23
  • 最后修改日期:2012-11-16
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