玻璃体腔注射Bevacizumab(Avastin)治疗湿性ARMD临床观察
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Clinical observation of intravitreous injections of Bevacizumab (Avastin) for exudative age-related macular degeneration
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    摘要:

    目的:观察玻璃体腔注射bevacizumab(avastin)治疗湿性年龄相关性黄斑变性(age-related macular degeneration,ARMD)的疗效和安全性。方法:对22例22眼湿性ARMD患者行玻璃体腔注射bevacizumab1.25mg,间隔6wk再注射1次,第12wk对检查发现黄斑区水肿或渗漏明显的再注射1次。随访6mo,术后第1wk;1,3,6mo行视力、眼压、裂隙灯、间接检眼镜及光学相干断层扫描(optical coherence tomography,OCT)检查,第3,6mo行荧光素眼底血管造影(fundusfluorescence angiography,FFA)、彩色眼底照相检查,分析治疗前后患者平均视力及黄斑中心视网膜厚度(centralmacular thickness,CMT)的改变。结果:至第6mo随访,平均视力较治疗前有所提高,平均CMT比治疗前减少92.59μm,均有显著意义;FFA显示黄斑区渗漏均消失或明显减轻。除4例局部球结膜下出血,没有观察到其他不良反应。结论:玻璃体腔注射bevacizumab能够提高湿性ARMD患者的视力,减轻黄斑水肿;重复注射可以巩固疗效,减少复发。长期效果和安全性还需要更多病例和更长随访观察时间来评估。

    Abstract:

    ·AIM:To evaluate the safety and efficacy of the exudative age-related macular degeneration(ARMD)treated with intravitreal injections of bevacizumab(avastin).·METHODS:Totally 22 patients(22 eyes)with exudative ARMD were treated with intravitreal injections of bevacizumab(1.25mg),and reinjected at 6-week intervals.The patients who had macular edema or leakage(according to the results of the examination on the 12th week)were given another injection.After 6-month-follow-up,the changes of the average visual acuity and central macular thickness(CMT)were analyzed through the results of the optical coherence tomography(OCT)(1st week,1st month,3rd month and 6th month after the operation)and fundus fluorescence angiography(FFA)(3rd month and 6th month after the operation).·RESULTS:After 6-month-follow-up,the average visual acuity was improved,the average CMT was reduced by 92.59μm,and both data were significant to the treatment efficacy,macular edema and leakage were disappeared or obviously alleviated through FFA.No other adverse effects were observed except four cases of subconjunctival hemorrhage.·CONCLUSION:Intravitreal injections of bevacizumab can improve the visual acuity of exudative ARMD patients and alleviate macular edema.Repeating injection can improve the efficacy and reduce the rate of recurrence.Long-term efficacy and safety of this treatment need to be evaluated with more cases and further follow-up.·

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洪浩,刘庆淮.玻璃体腔注射Bevacizumab(Avastin)治疗湿性ARMD临床观察.国际眼科杂志, 2010,10(11):2176-2178.

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