贝伐单抗玻璃体内注射治疗特发性脉络膜新血管形成的远期效果观察

Observation on long-term efficacy of intravitreal injection of Bevacizumab for idiopathic choroidal

目的观察贝伐单抗玻璃体内注射治疗特发性脉络膜新血管形成（ICNV）的远期效果和安全性。方法对37例（37眼）接受玻璃体内注射贝伐单抗治疗的ICNV进行为期5年的追踪观察，记录患者末次治疗后1个月、6个月、1、2、3、4和5年的视力（BCVA）、黄斑中心区厚度（CMT）。结果37例（37眼）中25例注射3次，12例注射2次。治疗前平均BCVA（10gMAR）0．632±0．293，末次治疗后1个月为0．295±0．156，差异具有统计学意义（t=-29．784，P=0．000），治疗前患者CMT为（299．914±38．283）μm，末次治疗后为（187．228±35．134）μm，差异具有统计学意义（t=49．936，P=0．000）。末次治疗后随访期间各时间点的BCVA和CMT经统计学分析，差异均无统计学意义（F=0．906，P=0．832；F=1．407，P=0．289）。结论玻璃体内注射贝伐单抗能够迅速改善ICNV患者的病情，且远期（5年）疗效稳定。

Objective To observe the long-term efficacy and safety of intravitreal injection of Bevacizumab （Avastin） in the treatment of idiopathic choroidal neovascularization （ICNV）. Methods Thirtyseven eyes of 37 patients with ICNV underwent intravitreal injection of Bevacizumab. The followed up time was 5 years. The BCVA of patients and central macular thickness （CMT） were recorded at 1 month, 6 months, 1 year, 2 years, 3 years, 4 years and 5 years after last injection. Results Thirty-seven eyes of 37 patients （ including 17 male and 20 female） received injections. The injection times were 3 injections in 25 cases. And the other 12 cases had 2 injections. The BCVA （logMAR） （0. 295 ±0. 156） at 1 month after last injection was much better than （ 0. 632 ± 0. 293 ） before injection. The difference was statistically significant（t = - 29. 784, P = 0. 000）. The CMT was （299. 914 ± 38. 283 ） μm before injection, and （187. 228 ± 35. 134）μm at 1 month after last treatment. The difference was statistically significant （t = 49. 936, P = 0.000） . There was no difference among 1 month, 6 months, 1 year, 2 years, 3 years, 4 years or5 years after last injection in BCVA and CMT（F=0. 906,P =0. 832; F = 1. 407, P =0.289）. Conclusion Intravitreal injection of Bevaeizumab is effective and safe for patients with ICNV for long time follow-up （5 years）.