玻璃体腔内注射贝伐单抗(阿瓦斯丁)治疗老年性黄斑变性新生血管后光学相干断层扫描结果

To determine whether intravitreal bevacizumab could improve optical coherence tomography and visual acuity outcomes in a patient with neovascular age-related macular degenerationwho was responding poorly to pegaptanib therapy, an intravit real injection of bevacizumab (1.0 mg) was given. Within 1 week, optical coheren ce tomography revealed resolution of the subretinal fluid, resulting in a normal -appearing macular contour. The improved macular appearance was maintained for at least 4 weeks, and visual acuity remained stable. No inflammation was observe d. An intravitreal injection of bevacizumab may provide an effective, safe, and inexpensive option for patients with age-related macular degeneration who are l osing vision secondary to macular neovascularization.

Ranibizumab治疗新生血管性老年性黄斑病变

Vascular endothelial growth factor (VEGF) is considered to play an es sential role in the pathogenesis of age-relatedma- cular degeneration due to its vascular permeability-inducing and angiogenic p roperties. Ranibizumab, a small antibody fragment designed to competitively bind all VEGF isoforms, passes after intravitreal injection all retinal layers reach ing the retinal pigment epithelium-choroid complex. Experimental animal models showed the drug to be safe and effective. Subsequently, Phase I/II clinical tria ls conducted in patients with neovascular AMDdemonstrated a good safety profile, and a significant functional benefit. Ranibizumab therapy repeated every four we eks for the treatment of neovascular AMD is currently in Phase III clinical tria ls. Combination therapy trials aiming for improved treatment durability and effe ctiveness are currently ongoing as well as new treatment strategies using interm ittent, optical coherence tomography (OCT) guided therapy. Anti-VEGF therapy us ingRanibizumab is a promising newtreatment option for neovascular AMD.

维替泊芬治疗眼组织胞浆霉菌病的光动力学疗法:2年的无对照开放性跟踪研究

Objective To evaluate the safety, effect on visual function, and fluorescein a ngiographic appearance of subfoveal choroidal neovascularization (CNV) through 2 years after photodynamic therapy with verteporfin (Visudyne; Novartis AG, Basel , Switzerland) in patients with ocular histoplasmosis syndrome (OHS). Design Ope n-label, 3-center, uncontrolled clinical study. Participants Ocular histoplasm osis syndrome patients with subfoveal CNV (N=26) with a greatest linear dimensio n no larger than 5400 μm with classic or occult CNV extending under the geometr ic center of the fovea, and best-corrected visual acuity letter score of approx imately 20/40 to 20/200. Methods The methods were similar to those described in the 1-year results with follow-up examinations every 3 months continuing throu gh the second year. During the second year, additional therapy was recommended i f fluorescein angiography showed leakage at a scheduled visit. Main outcome meas urements Visual function measurements included the changes from baseline in visu al acuity and contrast sensitivity scores. Lesion size and leakage from classic and occult CNV were assessed at month 12 and month 24. Safety assessments also w ere made. Results A 24-month examination was completed in 22 of the 26 enrolled participants (85%). At the 24-month examination, median improvement from base line in visual acuity of the 22 patients evaluated was 6 letters; median contras t sensitivity improved by 3.5 letters. At the 24-month examination, 10 patients (45%) gained 7 or more letters of visual acuity from baseline, whereas 4 patie nts (18%) lost 8 or more letters, including 2 patients (9%) who lost at least 15 letters. There was absence of fluorescein angiographic leakage from classic C NV in 17 of the 20 evaluable lesions (85%), and leakage from occult CNV was abs ent in all eyes. No serious ocular adverse events were reported, and no serious systemic event was considered to be associated with treatment. Conclusions Media n visual acuity improved and fluorescein angiographic leakage decreased after ve rteporfin therapy in this small, uncontrolled clinical study of patients with su bfoveal CNV resulting from OHS. Verteporfin therapy seemed to be relatively safe in these patients. The selected cases feature fluorescein angiographic examples of CNV that are important in determining when to apply verteporfin therapy.

视网膜中央静脉阻塞继发黄斑水肿患者玻璃体腔内注射贝伐单抗(阿瓦斯丁)后的光学相干断层扫描结果

To determine whether bevacizumab could improve visual acuity and optical coher ence tomography outcomes in a patient with macular edema from central retinal ve in occlusion, an intravitreal injection of bevacizumab (1.0 mg) was given. Prior intravitreal injections of triamcinolone acetonide resulted in vision improveme nt butworsening cataract and borderline glaucoma. Within 1 week of the bevacizum ab injection, visual acuity improved from 20/200 to 20/50 and optical coherence tomography revealed resolution of the cystic maculopathy. The improvements were maintained for at least 4 weeks. Intravitreal injections of bevacizumab may prov ide another treatment option for patients with macular edema from vein occlusion s.