连续玻璃体腔内注射Bevacizumab治疗糖尿病性黄斑水肿

Consecutive intravitreal injection of Bevacizumab for the treatment of diabetic macular edema

目的观察连续玻璃体腔内注射Bevacizumab治疗糖尿病性黄斑水肿(DME)的临床疗效及安全性。方法患者46例56眼,经眼底检查、视网膜血管荧光造影(FFA)、光学相干断层扫描(OCT)确诊为糖尿病性黄斑水肿。患者年龄26～74岁,平均(56±9)岁。治疗前平均logMAR最佳矫正视力为1.012±0.42,黄斑中心凹厚度平均(576±136)μm,分别接受连续玻璃体腔内注射Bevacizumab 1.25 mg(0.05 ml)3～5次,平均(4±1)次,每次间隔1个月。治疗后随访6～12个月,平均(9±3)个月。对比治疗前后视力、眼压、黄斑中心凹厚度及FFA改变。结果 46例患者随访6～12个月,平均logMAR最佳矫正视力提高到0.65±0.44,与治疗前比较差异有统计学意义(P<0.05)。其中36眼logMAR最佳矫正视力提高2行或以上,占64.29%。OCT示:黄斑中心凹厚度降低到(275±103)μm,与治疗前比较差异有统计学意义(P<0.05)。治疗过程中未发现严重不良反应。结论连续玻璃体腔内注射Bevacizumab 1.25 mg(0.05 ml)治疗糖尿病性黄斑水肿能明显改善视功能,减轻黄斑水肿,未发现严重不良反应。

Objective To evaluate the efficiency and sfety of consecutive intrm4treal injection of Bevacmab in patients with diabetic macular edema. Methods Prospect/re, open - label study of 56 eyes of 46 patients with diabetic macular edema which was diagnosed by examination of regular inspection, funds fluorescein angiography （FFA） and optic coherence tomography （OCT）. Patients aged from 26 to 80 years with a mean age of （ 56 ± 9） years. The best corrected visual acuity of logMAR was 1. 012 ± 0.42 and the mean central macular thickness （CMT） was （576 ± 136） μm. The patients received comccutive intravitre- ons injection of 1.25 rag（ 0.05 ml） Bevacizumab at 1 month intervals. After the treatment, the follow -up period ranging from 6 to 12 months,mean （9 ± 3）months. The changes of visual acuity, intraocar pressure, OCT and FFA before and after the treatment were observed and analyzed. Resnlts All patients had a mean IogMAR BCVA of 1. 012 ± 0.42 at baseline, and during the follow-up, the mean IogMAR BCVA was significantly improved as 0.65 ±0.44, and the differences are statistically significant compared with before （ P 〈 0.05）. The BCVA was improved in 36 eyes （64.29%）. The mean central macular thickness was （576 ±136）μm in preinjection and （275 ± 103） 0an in postinjeetion, showing a statistically sigtfificant difference between them （ P 〈 0.05）. No significant adverse events of ocular or systemic tissue occurred. Conclusion The preliminary result in our observation showed that consecutive intravitreal injection of Bevacizumab therapy is well tolerated with a significant improvement in BCVA and decrease in macuIar edema for patients with diabetic macular edema.