目的:系统评价贝伐单抗辅助玻璃体切除术(pars plana vitrectomy,PPV)治疗增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的疗效。方法:计算机检索Cochrane Library、Medline、Embase、中国生物医学文献数据库(CBM)...目的:系统评价贝伐单抗辅助玻璃体切除术(pars plana vitrectomy,PPV)治疗增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的疗效。方法:计算机检索Cochrane Library、Medline、Embase、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP)、中国期刊全文数据库(CNKI)、万方数字化期刊全文数据库,查找以贝伐单抗辅助PPV治疗PDR的随机对照试验(randomized controlled trials,RCTs)或对照试验,对纳入的实验进行质量评价,采用Rev Man 5.1软件进行Meta分析。结果:共纳入7项RCTs,包括319只眼(实验组:167只眼,对照组:152只眼)。Meta分析结果提示,实验组术后视力恢复程度较对照组好(OR=-0.37,95%CI=-0.45^-0.30,P=0.000)且手术时间较短(MD=-17.37,95%CI=-29.32^-5.42,P=0.004)。实验组术中出血、电凝次数、医源性视网膜裂孔等发生例数较对照组少,术中出血(OR=0.06,95%CI=0.02~0.18,P=0.000);电凝次数(OR=0.07,95%CI=0.02~0.22,P=0.000)医源性视网膜裂孔(MD=-17.37,95%CI=-29.32^-5.42,P=0.003);术后玻璃体再积血较对照组少(OR=0.36,95%CI=0.20~0.64,P=0.000);术后视网膜脱离,眼压升高两组无差异[视网膜脱离(OR=0.35,95%CI=0.12~1.01,P=0.050;眼压升高(OR=0.48,95%CI=0.18~1.23,P=0.130)]。结论:贝伐单抗辅助PPV治疗PDR疗效较单一PPV治疗好,并且可以减少术中、术后并发症。展开更多
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...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.展开更多
文摘目的：观察玻璃体内注射贝伐单抗对增殖性糖尿病视网膜病变（proliferative diabetic retinopathy,PDR）伴玻璃体积血的治疗效果。方法：选择2013-01/2015-08于我院诊断为PDR伴玻璃体积血的患者共46例50眼,其中28例30眼接受贝伐单抗治疗,设为注药组;另外18例20眼作为对照组,对照组除未接受贝伐单抗注射外其他治疗方法及随诊等均同注药组。观察记录两组患者4wk后玻璃体积血吸收情况、术后最佳矫正视力、玻璃体再出血等情况。对于两组患者,贝伐单抗注射后每周随访,若出血吸收,眼底可看清,则及时行荧光素眼底血管造影及视网膜激光治疗;注药后4wk,若玻璃体积血无明显吸收或积血加重者,或随访过程中出现视网膜牵引脱离者,则及时行玻璃体切除术（pars plana vitrectomy,PPV）,随诊时间3mo。结果：随访3mo后,两组患者共避免玻璃体切除术10眼,其中注药组9眼（30%）,对照组1眼（5%）,两组间比较差异有统计学意义（χ^2=6.108,P=0.0171）。随访3mo后注药组视力提高19眼（63%）,对照组视力提高7眼（35%）,组间比较差异有统计学意义（χ^2=6.102,P=0.014）。两组患者中共40眼行玻璃体切除手术,注药组21眼中有5眼玻璃体腔硅油填充（24%）,对照组19眼中有12眼玻璃体腔硅油填充（63%）,硅油填充眼数比较差异有统计学意义（χ^2=5.2849,P=0.0137）。结论：贝伐单抗玻璃体腔注射后可以使部分PDR伴玻璃体积血患者避免玻璃体切除手术,降低手术难度,减少眼内硅油填充率和术后再出血,提高术后视力。
文摘目的:系统评价贝伐单抗辅助玻璃体切除术(pars plana vitrectomy,PPV)治疗增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的疗效。方法:计算机检索Cochrane Library、Medline、Embase、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP)、中国期刊全文数据库(CNKI)、万方数字化期刊全文数据库,查找以贝伐单抗辅助PPV治疗PDR的随机对照试验(randomized controlled trials,RCTs)或对照试验,对纳入的实验进行质量评价,采用Rev Man 5.1软件进行Meta分析。结果:共纳入7项RCTs,包括319只眼(实验组:167只眼,对照组:152只眼)。Meta分析结果提示,实验组术后视力恢复程度较对照组好(OR=-0.37,95%CI=-0.45^-0.30,P=0.000)且手术时间较短(MD=-17.37,95%CI=-29.32^-5.42,P=0.004)。实验组术中出血、电凝次数、医源性视网膜裂孔等发生例数较对照组少,术中出血(OR=0.06,95%CI=0.02~0.18,P=0.000);电凝次数(OR=0.07,95%CI=0.02~0.22,P=0.000)医源性视网膜裂孔(MD=-17.37,95%CI=-29.32^-5.42,P=0.003);术后玻璃体再积血较对照组少(OR=0.36,95%CI=0.20~0.64,P=0.000);术后视网膜脱离,眼压升高两组无差异[视网膜脱离(OR=0.35,95%CI=0.12~1.01,P=0.050;眼压升高(OR=0.48,95%CI=0.18~1.23,P=0.130)]。结论:贝伐单抗辅助PPV治疗PDR疗效较单一PPV治疗好,并且可以减少术中、术后并发症。
文摘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.
