玻璃体腔注射Avastin治疗急性中心性浆液性脉络膜视网膜病变的短期疗效

Short-term efficacy of introvitreal injection of Avastin for acute central serous chorioretinopathy

目的探讨玻璃体腔内注射Avastin治疗急性中心性浆液性脉络膜视网膜病变(简称中浆)的有效性和安全性。方法回顾分析2009-01～2009-06期间经3D-OCT检测确诊的15眼急性中浆伴有视力下降的患者,病程为0.5-8周。所有患者均进行一次玻璃体腔内Avastin注射(2.5mg/0.1ml)。注射后1周、1个月和3个月均对患者进行矫正视力和OCT的检测,且在注射前和注射后1个月、3个月时对患眼进行眼底荧光血管造影(FFA)的检查。结果15眼在治疗后随访,3D-OCT显示:术后1周仅有5眼患者视网膜下液部分吸收,其余10眼变化不明显;术后1个月和3个月时,可见14例患眼视网膜下液几乎全部吸收,视网膜神经上皮层与色素上皮层贴附较好,荧光造影中无渗漏,但有1例患者在术后3个月检查时视网膜下液仍无明显吸收,造影中显示轻度荧光渗漏;15眼视力由术前平均0.44提高至术后3个月时0.82。随访期间未见眼内炎、视网膜裂孔和视网膜脱离等并发症的发生。结论玻璃体腔内注射Avastin对急性期中浆患者的治疗在短期内是安全有效的。3D-OCT可清晰观察视网膜下液的吸收情况,FFA可准确观察病灶局部在治疗前后的渗漏情况。

Objective To investigate the safety and efficacy of intravitreal injection of Avastin for acute central serous chorioretinopathy（CSC）. Methods The clinical data of 15 eyes of acute CSC diagnosed by three dimensional optical coherence tomography （3D- OCT） from Jan. 2009 to June 2009 were retrospectively analyzed. All patients were intravitreally injected with Avastin （2.5 mg/0.1 ml） and followed up. The course of disease was 0.5 - 8 weeks. The average vision acuity decreased to 0.44. Fifteen eyes were imaged by 3D-OCT at day 7 ,month 1 and 3 after injection. In the meanwhile,all eyes were performed FFA before and after injection for 1 month and 3 months to observe the leakage of local area of retina. Results The result of 3D-OCT showed that subretinal fluid （SRF） was partly absorbed in 5 eyes after followed-up,but no change after one week was observed in the other 10 eyes. SRF of 14 eyes almost disappeared at month 1 and 3 and retinal neurosensory layer and retinal pigment epithelium were attached well, and no leakage was found by FFA at month 1 and 3. One eye still had SRF and slight leakage at month 3. The vision acuity increased to 0.82 at month 3. No endophthalmitis, retinal hole and retinal detachment were found during treatment. Conclusion The intravitreal injection of Avastin is safe and effective in short term evaluation. 3 D-OCT can clearly image the fluid of subretinal space, and FFA can be used to correctly observe the local leakage on the retina.