玻璃体腔注射贝伐单抗治疗糖尿病性黄斑水肿疗效观察  

Intravitreous bevacizumab(Avastin) therapy for diffuse diabetic macular edema

作　　者：钱彤[1] 黎晓新[1] 尹虹[1] 梁建宏[1] 齐慧君[1] 

机构地区：[1]北京大学人民医院眼科,100044

出　　处：《眼科研究》2009年第2期118-121,共4页Chinese Ophthalmic Research

摘　　要：目的评估玻璃体腔注射贝伐单抗bevacizumab(Avastin)治疗糖尿病性黄斑水肿(DME)的疗效。方法回顾分析接受玻璃体腔注射Avastin治疗DME的患者57例(68眼),所有患者均接受玻璃体腔内注射Avastin1.25mg(0.05mL)。治疗前及治疗后1、2、3d,3、6、12周进行最佳矫正视力(BCVA)、眼压、裂隙灯及间接检眼镜检查。治疗前及治疗后3、6、12周行光学相干断层扫描(OCT)检查。治疗前及治疗后6周、12周行彩色眼底照相、荧光素眼底血管造影(FFA)检查。有21、13、2眼分别需要注射2、3、4次。随访时间2～19个月,平均(3.10±1.62)个月。对比分析治疗前后患者视力及黄斑中心视网膜厚度(CMT)的改变。结果治疗后患者视力明显提高,CMT平均值治疗前为(506.19±153.78)μm,治疗后3、6、12周时均明显减低(t=3.45,3.18,3.46,P<0.05),治疗后末次随诊时为(379.10±166.32)μm,与术前相比差异有统计学意义(t=4.719,P=0.000)。随访中未见眼压异常改变及白内障的进展,未见与药物有关的眼部和全身不良反应。结论玻璃体腔注射Avastin后,黄斑水肿明显减轻,视力稳定并提高,必要时需要连续注射治疗,长期效果需进一步观察。Objective Retinal photoeoagulation is beneficial for improving the visual acuity in the patients with macular edema,hut its outcome is not satisfied for diffuse macular edema. This study was to evaluate the efficacy of bevacizumab（Avastin） on diffuse diabetic macular edema. Methods The clinical data of 68 eyes（57 patients） with diffuse maeular edema received intravitreous injection of 1.25 mg （0. 05 mL） bevacizumab （Avastin） were retrospectively analyzed. The best corrected visual acuity（BCVA） , slit-lamp examination,intraocular pressure measurement and stereoscopic biomieroseopy examination were carried out before injection and at 1 day, 2 days, 3 days, 3 weeks, 6 weeks and 12 weeks after initial injection. Optical coherence tomography（OCT） was performed prior to injection and 3,6,12 weeks after initial injection. Fundus photography, fluoreseein fundus angiography（FFA） were performed prior to injection and 6,12 weeks after initial injection. The follow-up period was 2 - 19 months. The changes of BCVA and central macular thickness （CMT） of all the eyes were evaluated before and after the injection. Results The BCVA was improved in 29 eyes （42.6%）, stable in 35 eyes （51.5%） and decreased in 4 eyes （5.9%） during the follow-up. The mean central macular thickness was（506.19 ＋ 153.78） μm in preinjection and（379.10 ＋ 166.32）μm in postinjection, showing a statistically significant difference between them （t = 4. 719, P = 0. 000）. No significant change in lOP and eataraet progression were observed. No adverse events of ocular or systemic tissue occurred. Conclusion The intravitreal injection of bevacizumab（Avastiu） can relieve diffuse maeular edema and damage of visual function.

关 键 词：贝伐单抗 糖尿病视网膜病变 黄斑水肿 

分 类 号：R774.5[医药卫生—眼科] R587.1[医药卫生—临床医学]