Intravitreal Bevacizumab (Avastin) for Choroidal Neovascularization Secondary to Pathologic Myopia: A Short Term Result

使用Bevacizumab治療病理性近視黃斑部病變經驗

黃楷涵(Kai-Han Huang) ； 鄭成國(Cheng-Kuo Cheng) ； 彭繼賢(Chi-Hsien Peng) ； 李東昇(Tong-Sheng Lee) ； 胡朝乾(Chao-Chen Hu) ； 吳慈恩(Tzu-En Wu) ； 林惠真(Hui-Chen Lin) ； 彭百慧(Pai-Hui Peng)

《中華民國眼科醫學會雜誌》 47卷4期 (2008/12) Pp. 410-420

https://doi.org/10.30048/ACTASOS.200812.0003

摘要

目的：報告及評估玻璃體內注射bevacizumab藥物來治療病理性近視引起之黃斑部脈絡膜新生血管其安全性及成效。
方法：自2006年4月至2007年3月期間內，我們收集13位病人，接受玻璃體內注射bevacizumab 2.5 mg來治療病理性近視引起之黃斑部脈絡膜新生血管病變。
結果：15隻眼睛中，注射術前最佳矯正視力平均是logMAR 0.89±0.59；平均追蹤4.8個月，注射術後最佳矯正視力平均是logMAR 0.58±0.61。在最後一次追蹤時，有5隻眼睛(33.3%)視力進步達六行或以上，2隻眼睛(13.3%)視力進步達三行至五行之間。黃斑部中央窩的厚度平均下降55.73 μm。沒有觀察到任何因藥物或者是注射手術引起的併發症。
結論：玻璃體內注射bevacizumab對是病理性近視引起之黃斑部脈絡膜新生血管病變安全而且有效的治療方式，可以觀察到視力及結構上的改善。

並列摘要

Purpose: To report the short-term study and evaluate the safety and efficacy of intravitreal bevacizumab in the treatment for choroidal neovascularisation (CNV) secondary to pathological myopia (PM).
Method: The non-randomized retrospective chart review recruited 15 eyes from 13 patients with primary or recurrent choroidal neovascularization secondary to pathological myopia who received intravitreal bevacizumab 2.5mg between April 2006 and March 2007 at the Shin-Kong Wu Ho-Su Memorial Hospital. Data from clinical examination, fundus photography, fluorescein angiography, central retinal thickness (CRT) determined from optical coherence tomography (OCT) and best-corrected visual acuity (BCVA) were collected.
Results: The spherical equivalent refractive error of the 15 eyes was ranged from -6.0 D to -12.25D. Four of 15 eyes had been treated previously with photodynamic therapy, transpupillary thermal therapy, or subtenon injection of triamcinolone. The average number of injection was 1.7 with a maximum of 5 injections. The pre-injection mean of the minimum angle of resolution (logMAR) BCVA at baseline was 0.89 ± 0.59 (Snellen equivalent, 6/47). After a mean follow-up of 4.8 (range 1-10) months, the mean post-injection logMAR BCVA was 0.58 ± 0.61 (Snellen equivalent, 6/23) at the last follow-up. Two eyes received two bevacizumab injections and two eyes received five injections. Visual acuity improved by six or more lines in 5 eyes (33.3%), improved by three to five lines in 2 eyes (13.3%), no significant change in 7 eyes (46.7%), and decreased by three lines was in 1 eye (6.7%) at the last follow-up. Central foveal thickness improved from 282.13 ± 39.7 (range 227-370) μm to 226.4 ± 35.6 (range 174-290) μm at last follow-up, representing an average reduction of 55.73 (range 0 to -84) μm. No significant ocular or systemic injection complications or drug-related side effects were observed.
Conclusions: The outcomes of this small case series suggest intravitreal bevacizumab to be a safe and promising treatment method for CNV secondary to PM with both visual and anatomic improvements.

並列關鍵字

pathologic myopia ； choroidal neovascularization ； intravitreal bevacizumab ； anti-VEGF