贝伐珠单抗治疗糖尿病性黄斑水肿的疗效观察

Clinical Observation of Bevacizumab in the Treatment of Diabetic Macular Edema

目的:评价玻璃体腔内注射贝伐珠单抗治疗糖尿病性黄斑水肿的临床效果与安全性。方法:对接受玻璃体腔注射Bevacizumab(1.75 mg)治疗的20例(26眼)糖尿病性黄斑水肿患者进行回顾性分析,对比分析治疗前后1、2、3、6月最佳矫正视力、眼压、黄斑中心凹厚度变化。对所有病例进行6月以上的随访观察。结果:在20例(26眼)患者中平均年龄(57±18.56)岁。治疗前患者的基线平均对数BCVA为(log MAR 0.82±0.63),CFT为(624.2±176.1)μm,注药后1周CFT没有显著改善,但BCVA有显著提高,经平均随访9.8 mo,BCVA,CFT均较基线有显著改善,差异有统计学意义(P<0.01)。终末随访时BCVA提高≥两行有22眼(84.6%),稳定2眼(7.7%)。本组患者共接受了92次玻璃体腔内注射,平均每眼注射次数为(3.98±1.52)次。结论:玻璃体腔内注射bevacizumab可明显改善糖尿病黄斑水肿患者的视力,减轻黄斑水肿,减少CNV渗漏,重复治疗效果更佳。但远期疗效尚须进一步观察。

Objective：To evaluate the clinical effect and safety of intravitreal injection of bevacizumab in the treatment of diabetic macular edema. Methods：The records of 26 eyes of 22 patients treated with intravitreal injection of 1.75mg bevacizumab for diabetic macular edema were retrospectively analyzed. Best corrected visual acuity （BCVA）, intraocular pressure, choroidal leaks, central retinal thickness （CFT） 1, 2, 3 months and 6 months before and after the treatment were analyzed and compared. Follow-up observation were carried out among all cases after 6 months. Results：26 eyes of 22 patients with the average of（57±18.56）years old were included. The mean baseline of BCVA, CFT were（logMAR 0.82±0.63）,（624.2±176.1）μm respectively. Although there was no significant decrease in mean CFT one week after the injection, the mean BCVA had significant improvement. At the last visit of 9.8 months＇ follow up, BCVA and CFT showed significant improvements over baseline values, which had a significant difference （P〈0.001）. BCVA was improved by at least two lines in 22 eyes（84.6%）, remained stable in 2 eyes（7.7%）at the last visit. A total of 92 injections were performed and the average number of injections was（3.98 ± 1.52）in the group. Conclusion： Intravitreal injection of bevacizumab can improve the visual acuity, reduce macular edema and choroidal leakage in patients with diabetic macular edema. Repeated treatment has better effect, but a prolonged treatment effect needs further observation.