抗VEGF药物治疗葡萄膜炎并发黄斑囊样水肿和脉络膜新生血管研究进展  

Research progress in topical application of anti-vascular endothelial growth factor drugs for uveitis-associated cystoid macular edema and choroidal neovascularization

作　　者：姚蕾[1] 宫媛媛[1] 孙晓东[1] 

机构地区：[1]上海交通大学附属第一人民医院眼科,200080

出　　处：《中华实验眼科杂志》2014年第7期659-663,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家973计划项目（2011CB707506）;上海市自然科学基金项目（12ZR1424500）;上海市眼底病重点实验室开放课题基金项目（07Z22911）

摘　　要：葡萄膜炎是累及眼后段的炎症性疾病,病程长,对视功能的损害明显,可出现黄斑囊样水肿（CME）、白内障、青光眼、视网膜脱离、脉络膜新生血管（CNV）等多种并发症.在葡萄膜炎的发病和进展过程中,炎性因子通过多种途径影响血管内皮生长因子（VEGF）的释放,研究已证实在并发CME的葡萄膜炎患者玻璃体腔内VEGF含量升高.玻璃体腔内注射抗VEGF药物,如雷珠单抗和贝伐单抗,治疗非感染性葡萄膜炎相关性CME及CNV对于大部分病例有效,且能改善患者的视力,但可能需多次反复注射.对于一些病程长,CME持续存在,或不宜应用糖皮质激素、免疫抑制剂进行治疗的患者,球内注射抗VEGF药物是可选择的有效方法,但这种方式可能对糖皮质激素的疗效产生一定的影响,仍需更多的临床观察与基础研究进一步证实.就应用抗VEGF药物治疗葡萄膜炎并发CME和CNV的研究现状和进展进行综述.Uveitis is a kind of inflammatory disease affected in ocular posterior segment.Uveitis sustains a long duration and causes a significant damage of visual function.It often leads to serious complications,such as cystoid macular edema （CME）,cataract,glaucoma,retinal detachment and choroidal neovascularization （CNV）.In the pathological process of uveitis,inflammatory factors promote the release of vascular endothelial growth factor （VEGF） through a variety of pathways.It has been verified that VEGF level is elevated in vitreous in the patients with uveiticinduced CME.Intravitreal injection of anti-VEGF drugs,including ranibizumab and bevacizumab,can improve the visual acuity in most patients with noninfectious uveitic-induced CME and CNV.However,intravitreously repeated injections of anti-VEGF drugs may be required in some patients.Intraocular injection of anti-VEGF drugs is an optional and effective way for those with persist macular edema and not being suitable for the use of corticosteroid or immunosuppressive therapy.However,anti-VEGF drugs may affect the efficacy of corticosteroid.Therefore,more clinical and basic researches are still needed.The status and progresses in the use of anti-VEGF drugs for uveitisinduced CME and CNV were reviewed.

关 键 词：葡萄膜炎 并发症 黄斑囊样水肿 脉络膜新生血管 血管内皮生长因子 雷珠单抗 贝伐单抗 

分 类 号：R773[医药卫生—眼科]