OCT对玻璃体腔内注射Bevacizumab治疗脉络膜新生血管的疗效评价  

Evaluation of intravitreal injection of Bevacizumab for treatment of choroidal neovascularization by optical coherence tomography

作　　者：钱锦[1] 许薇琦[1] 王卫峻[1] 孙晓东[1] 吴颖[1] 许迅[1] 张皙[1] 

机构地区：[1]上海交通大学第一人民医院眼科,上海200080

出　　处：《上海交通大学学报（医学版）》2009年第2期188-191,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市科研计划基金(FM-040102-203)~~

摘　　要：目的探讨光学相干断层扫描(OCT)在玻璃体腔内注射Bevacizumab治疗脉络膜新生血管(CNV)疗效评价中的作用。方法CNV患者23例(24眼),其中年龄相关性黄斑变性(AMD)19例(20眼),病理性近视(PM)4例(4眼)。所有患者每月玻璃体内注射Bevacizumab 2.5 mg/次,连续治疗3次;治疗前后检查视力,应用OCT观察黄斑区视网膜形态,并对黄斑区视网膜神经上皮层厚度进行测量。随访期1～7个月。结果24眼接受75次治疗(平均3.1次),无1眼发生不良反应。治疗后17眼(70.8%)早期治疗糖尿病视网膜病变研究(ETDRS)视力提高8个字符以上,7眼(29.2%)视力稳定。OCT检查显示,黄斑中心凹视网膜神经上皮层厚度治疗前为(355.83±113.21)μm,治疗后为(258.46±74.55)μm,差异有统计学意义(P<0.01);治疗后所有患眼黄斑区视网膜水肿均明显减轻,黄斑囊样水肿(4眼)、视网膜下积液(7眼)和色素上皮脱离(3眼)都有改善甚至消失。结论玻璃体内注射Bevacizumab治疗AMD和PM引起的CNV近期疗效良好;OCT具有准确、客观、方便、可重复性和定量的特点,为临床随访和评估抗血管内皮生长因子-A治疗效果提供了客观的指标。Objective To investigate the role of optical coherence tomography （OCT） in the evaluation of intravitreal injection of Bevacizumah for the treatment of choroidal neovascularization （CNV）. Methods Twenty-three patients （24 eyes） were diagnosed with CNV, among whom 19 （20 eyes） were age-related macular degeneration （AMD） and the other 4 （4 eyes） were pathologic myopia （PM）. Each patient received intravitreal injection of Bevacizumab （2.5 mg/month） for three months. Before and after treatment, visual acuity was measured, OCT was employed for the observation of retinal morphology of macular region, and macular retinal thickness was determined. All the cases were followed up for 1 to 7 months. Results Twenty-four eyes received 75 times of intravitreal injection in all, with 3.1 times for each eye. No adverse events occured. After treatment, visual acuity of 17 eyes （70.8%） was improved by 8 letters of Early Treatment Diabetic Retinopathy Study （ETDRS） Chart, while that of the other 7 eyes was stable. It was revealed by OCT that the neuroepithelial layer thickness of macular fovea was decreased from （355.83 ± 113.21 ） um （ before treatment） to （258.46 ± 74.55）um （ after treatment） （P 〈0.01 ）. Macular retinal edema （24 eyes）, macular cystoid edema （4 eyes）, suhretinal fluid （7 eyes） and retinal pigment epithelium detachment （3 eyes） were improved after treatment. Conclusion Intravitreal injection of Bevacizumab for the treatment of CNV secondary to AMD and PM may lead to a favourable outcome. OCT can objectively, accurately and effectively evaluate the efficacy of anti-VEGF-A therapy.

关 键 词：BEVACIZUMAB 脉络膜新生血管 光学相干断层扫描 

分 类 号：R773.4[医药卫生—眼科]