玻璃体腔内注射Bevacizumab治疗年龄相关性黄斑变性视野改变

目的 观察玻璃体腔内注射Bevacizumab(Avastin)治疗湿性年龄相关性黄斑变性(ARMD)术后各时间段的视野变化情况.方法 采用单中心随机临床研究方法.收集经间接眼底镜、荧光素眼底血管造影(FFA)以及光学相干断层扫描(OCT)检查确诊存在黄斑中心凹下脉络膜新生血管(CNV)的ARMD患者13例(15只眼),患眼最佳矫正视力均>0.1.患眼行Bevacizumab玻璃体腔内注射1.25mg(0.05ml),注射次数为6次,间隔6周至3个月,治疗后随访3～12个月,记录并分析术前及术后6周,3月,6月,12月的平均视觉敏感度(mean visual sensitivity,MS),平均缺损(mean defect,MD),缺损变异度(lose variance,Lv)的变化.结果 以0周注射为基准,第24周及48周MS值与注射前MS值相比有显著性差异(t值分别为2.91、3.69,P值均<0.05));第48周MD值与注射前MD值(7.97±3.97)dB差异有统计学意义(t值为1.35,P<0.05);各组LV值与注射前LV值比较差异无统计学意义.结论 多次玻璃体腔内注射Bevacizumab有利于改善湿性ARMD患者黄斑区视功能,主要体现在对视网膜平均敏感度以及平均缺损的改善上;重复4-6次注射后绝大多数湿性ARMD患者的视功能得到改善.

Visual field changes after intravitreal injections of Bevacizumab for neovascular age-related macular degeneration

Objective To evaluate visual field changes every time after systemic bevacizumab (Avastin) therapy in patients with choroidal neovascularization (CNV) related age-related macular degeneration (ARMD). Methods Single-center, uncontrolled clinical study. Thirteen CNV related ARMD patients (15 eyes) with best-corrected visual acuity (BCVA) more than 0.1 were determined by indirect ophthalmoscope, fundus fluorescein angiography (FFA) and optic coherence tomography (OCT). All these eyes were underwent 6 times intravitreal injections of bevacizumab (1.25mg, 0.05ml) at 6 w to 12 w intervals. The follow-up investigation time was from 3 to 12 months. Record and analyze the mean visual sensitivity (MS), mean defect (MD) and loss variance (LV) changes before and 6w, 12w. 24w, 48w after injections. Results Take 0 week as a baseline, we found MS values of 24th week and 48th week revealing a remarkable increase (t values were 2.91, 3.69 respectively, P<0.05). MD values at 48th week decreased when compared with that at 0 week (t value was 1.35, P <0. 05). There were no statistically significant differences when compared LV values within these groups. Conclusions Repeatedly intravitreal injections of bevacizumab are benefit for visual acuity of neovascular ARMD, especially changes in MS and MD values of macular retina. Visual acuity would improve in most of the neovascularization ARMD after 4-6 times injections.