玻璃體內注射癌思停於新生血管性青光眼治療之角色

Role of Intravitreal Bevacizumab in Neovascular Glaucoma

張昱欣(Yuh-Shin Chang) ； 張純(Chun Chang) ； 詹仁隆(Ren-Long Jan) ； 魏福宗(Fu-Tsung Wei)

《中華民國眼科醫學會雜誌》 53卷1期 (2014/04) Pp. 14-22

https://doi.org/10.30048/ACTASOS.201404_53(1).0003

摘要

目的：評估新生血管性青光眼在施行排多癌（Mitomycin C）小樑切除手術之前，以玻璃體內注射癌思停（Avastin）之效果。方法：回溯性、病例比較性研究。結果：本研究包括了14位新生血管性青光眼的病人（14眼）:其中7位病人只接受了排多癌小樑切除手術，為控制組（Control Group）；另外7位病人在接受排多癌小樑切除手術之前先行接受玻璃體內注射癌思停，為實驗組（IVB Group）。本研究比較了這兩種組別在流行病學、新生血管消退、排多癌小樑切除手術術後併發症以及手術後初期眼內壓力降低的差異。分析結果顯示，兩個組別在流行病學上並無顯著差異。而在實驗組觀察到在接受玻璃體內注射癌思停之後，有6眼虹膜新生血管完全消退（85.7%）。排多癌小樑切除手術術後併發症，如前房出血或是玻璃體出血，均是實驗組顯著降低。在接受排多癌小樑切除手術之後，無論控制組或是實驗組眼內壓力均顯著降低，其中又以實驗組較低。結論：在排多癌小樑切除手術之前先行接受玻璃體內注射癌思停對於新生血管性青光眼的治療確實有所助益。

並列摘要

Purpose: To evaluate the effects of intravitreal Bevacizumab (IVB) before Mitomycin C trabeculectomy (MMCT) for neovascular glaucoma (NVG). Methods: A retrospective, case-control study. Results: The study group consisted of 14 eyes from 14 patients with NVG who underwent an initial MMCT: 7 eyes were treated with MMCT alone (Control Group); and 7 eyes were treated with a combination of IVB and MMCT (IVB Group). Epidemiology, neovascularization regression, intraocular pressure (IOP), and surgical complications were compared between the two groups. No significant difference in epidemiology between the two groups was found. In the IVB group, complete regression of iris neovascularization after IVB injection occurred in 6 eyes (85.7%). Complications such as hyphema and vitreous hemorrhage were reduced in the IVB group. After MMCT, mean intraocular pressure was reduced significantly in both groups and was lower in the IVB group. Conclusion: Intravitreal Bevacizumab (IVB) before Mitomycin C trabeculectomy (MMCT) is a good treatment modality for the management of eyes with NVG.

並列關鍵字

Intravitreal Bevacizumab (IVB) ； Neovascular glaucoma (NVG) ； Mitomycin C trabeculectomy (MMCT) ； Regression of iris neovascularization ； Hyphema