抗血管内皮生长因子单克隆抗体Bevacizumab玻璃体腔注射治疗虹膜新生血管的临床观察

Abstract

目的 观察玻璃体腔注射抗血管内皮生长因子单克隆抗体Bevacizumab治疗增生型糖尿病视网膜病变(PDR)和视网膜中央静脉阻塞(CRVO)导致的虹膜新生血管(INV)的疗效. 方法回顾性分析2006年3月至2007年12月在北京大学人民医院眼科接受Bevacizumab玻璃体腔注射的39例INV患者47只眼的临床资料.其中,男性22例,女性17例,年龄28～82岁,平均年龄(57.77±13.0)岁,左眼23眼,右眼24只.PDR组26例34只眼;CRVO组13例13只眼.新生血管性青光眼(NVG)29只眼,其中,PDR组有20只眼,CRVO组有9只眼.所有患眼玻璃体腔注射Bevacizumab 1.25 mg/0.05 ml.注药后1、3、7 d,3、6周随访,观察注射前后视力、眼压变化以及INV消退情况. 结果PDR患眼中,视力提高者19只眼,占PDR患者的55.9%;不变者15只眼,占PDR患者的44.1%;无视力下降者.CRVO患眼中,视力提高者4只眼,占CRVO患者的30.8%;不变者9只眼,占CRVO患者的69.2%;无视力下降者.PDR的NVG患者中,16只眼眼压下降,占PDR患者的80.0%;CRVO的NVG患者中,6只眼眼压下降,占CRVO患者的66.7%.PDR患者中INV消退总有效率97.1%;CRVO患者INV消退总有效率84.6%.结论 Bevacizumab对于INV的治疗有满意的临床疗效,对其远期疗效、安全性和并发症还有待进一步观察.

Objective To evaluate the efficacy of intravitreal injection with Bevacizumab for iris neovascularization(INV)which caused by proliferative diabetic retinopathy(PDR)or central retinal vein occlusion(CRVO). Methods The clinical data of 39 patients(47 eyes)with INV who undergone intravitreal injection with Bevacizumab from 12,2006 to 3,2007 in Department of Ophthalmology,People's Hospital of Peking University were retrospectively analyzed.The patients(22 males and 17 females,23left eyes and 24 right eyes)aged from 28 to 82 years with the average of(57.77±13.0)years.26 cases (34 eyes)were PDR and 13 cases(13 eyes)were CRVO.All of patients underwent intravitrealinjection with 1.25 mg/0.05 ml Bevacizumab.Follow-up time was 1 day,3 days,1 week,3 weeks and 6 weeks after the treatment.The visual acuity,changes of intraocular pressure and changes of INV before and after the treatment were observed and analyzed. Results In patients with PDR,the visual acuity was improved in 19 eyes(55.9%),was stable in 15 eyes(44.1%)and none decreased.In patients with CRVO,the visual acuity was improved in 4 eyes(30.8%),was stable in 9 eyes(69.0%)and none decreased.Among neovascular glaucoma(NVG),decrease of IOP was noticed in 16 eyes with PDR (80%)and 6 eyes with CRV0(66.7%).Regression of INV was noticed in 97.1%PDR patients and 84.6%CRVO patients. Conclusions Intravitreal injection with Bevacizumab is very effective in treating INV.Further researches still needs to explore long term efficacy,safety and complications of this treatment.