[1]黎铧,李娟娟.抗VEGF药物玻璃体内注射治疗视网膜血管样条纹继发脉络膜新生血管的远期观察[J].眼科新进展,2017,37(10):947-950.[doi:10.13389/j.cnki.rao.2017.0240]
 LI Hua,LI Juan-Juan.Long-term outcomes of intravitreal injection of anti-VEGF medication in the treatment of choroidal neovascularization secondary to angioid streaks[J].Recent Advances in Ophthalmology,2017,37(10):947-950.[doi:10.13389/j.cnki.rao.2017.0240]
点击复制

抗VEGF药物玻璃体内注射治疗视网膜血管样条纹继发脉络膜新生血管的远期观察/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年10期
页码:
947-950
栏目:
应用研究
出版日期:
2017-10-05

文章信息/Info

Title:
Long-term outcomes of intravitreal injection of anti-VEGF medication in the treatment of choroidal neovascularization secondary to angioid streaks
作者:
黎铧李娟娟
650021 云南省昆明市,云南省第二人民医院眼科
Author(s):
LI HuaLI Juan-Juan
Department of Ophthalmology,No 2 People’s Hospital,Kunming 650021,Yunnan Province,China
关键词:
抗VEGF视网膜血管样条纹脉络膜新生血管OCT
Keywords:
anti-VEGF medicationretinal angioid streakschoroidal neovascularizationoptical coherence tomography
分类号:
R774.6
DOI:
10.13389/j.cnki.rao.2017.0240
文献标志码:
A
摘要:
目的 探讨视网膜血管样条纹继发脉络膜新生血管(choroidal neovascularization,CNV)抗VEGF治疗的远期疗效。方法 回顾分析接受玻璃体内注射抗VEGF药物的视网膜血管样条纹继发CNV患者,观察至少3 a后患者视力改善情况、视网膜及脉络膜活动性病灶消退情况等指标。结果 纳入分析的21例(30眼)患者中,眼内注射次数6~18(10.0±2.4)次。随访36~54(39.5±2.2)个月。患者首次接受治疗时BCVA为(31.00±3.81)个字母数,观察终点时最佳矫正视力为(34.00±0.35)个字母数,总体差异无统计学意义(P=0.600)。患者治疗前视网膜中央厚度为(406.21±21.23)μm,随访终末时为(251.16±36.36)μm,减少值为(150.21±24.43)μm,治疗前后视网膜中央厚度比较差异有统计学意义(P=0.002)。30眼中16眼在初期治疗后视力明显提升,但随访中出现病变复发活跃后视力再次下降至基线水平;10眼在病变过程中出现不同程度黄斑下萎缩及瘢痕化改变,随访过程及随访终末视力与基线视力差异均无统计学意义(均为P>0.05);4眼由于初始CNV未累及黄斑区,在治疗随访过程中CNV稳定。结论 由于病变的高复发性及强活跃性,抗VEGF药物治疗血管样条纹继发CNV远期预后并不理想,治疗仅发挥了一定维持视功能的作用。
Abstract:
Objective To evaluate the long-term follow-up efficacy of intravitreal injection of anti-VEGF medication for choroidal neovascularization (CNV) caused by angioid streak.Methods A retrospective observational study was conducted in 21 patients (30 eyes) diagnosed as subfoveal CNV caused by angioid streak.Demographic data,clinical course,visual acuity,and findings of fluorescein angiography and optical coherence tomography (OCT) were evaluated and observed at least 3 years after anti-VEGF treatment.Results Of all patients,the number of anti-VEGF injections was 6 to 18,with the average of 10±2.4,and the follow-up duration was 36 to 54 months,an average of (39.5±2.2)months.Moreover,the mean best corrected visual acuity (BCVA) at the baseline was (31.0±3.81) characters,and the mean BCVA was (34.0±0.35) characters at the final follow-up,and the total difference was not statistically significant (P=0.600).The baseline central retinal thickness (CRT) was (406.21±21.23)μm and (251.16±36.36)μm at the end of the follow-up,and the difference of CRT before and after the treatment was statistically significant (P=0.002).Visual acuity of 16 eyes in 30 eyes was significantly improved after the initial treatment,but decreased to the baseline level in the follow-up because of CNV recurrence,10 eyes occurred varying degrees of macular atrophy and scarring changes,and there was no significant difference between visual acuity of the follow-up and the baseline (all P>0.05),and 4 eyes had stable CNV during the follow-up because the initial CNV did not involve the macular area.Conclusion The long-term outcomes of anti-VEGF treatment for choroidal neovascularization secondary to angioid streaks is not satisfactory due to its high recurrence and activity.

参考文献/References:

[1] GEORGALAS I,TSERVAKIS I,PAPACONSTANINOU D,KARDARA M,KOUTSANDREA C,LADAS I.Pseudoxanthoma elasticum,ocular manifestations,complications and treatment[J].Clin Exp Optom,2011,94(2):169-180.
[2] AL-RASHAED S,AREVALO JF.Long-term follow-up of choroidal neovascularization secondary to angioid streaks:case series and literature review[J].Clin Ophthalmol,2012,6(5):1029-1034.
[3] GLIEM M,FINGER RP,FIMMERS R,BRINKMANN CK,HOLZ FG,CHARBEL ISSA P.Treatment of choroidal neovascularization due to angioid streaks:a comprehensive review[J].Retina,2013,33(9):1300-1314.
[4] TEIXEIRA A,MORAES N,FARAH ME,BONOMO PP.Choroidal neovascu larization treated with intravitreal injection of bevacizumab (Avastin) in angioid streaks[J].Acta Ophthalmol Scand,2006,84(6):835-836.
[5] IACONO P,BATTAGLIA PARODI M,LA SPINA C,BANDELLO F.Intravitreal bevacizumab for nonsubfoveal choroidal neovascularization associated with angioid streaks:3-Year Follow-up Study[J].Am J Ophthalmol,2016,165(5):174-178.
[6] MARTINEZ-SERRANO MG,RODRIGUEZ-REYES A,GUERRERO-NARANJO JL.Long-term follow-up of patients with choroidal neovascularization due to angioid streaks[J].Clin Ophthalmol,2016,19(11):23-30.
[7] YOLCU U,GUNDOGAN FC,DINER O.Drastic effect of ranibizumab on choroidal neovascularization in idiopathic angioid streaks[J].Arq Bras Oftalmol,2015,78(4):257-259.
[8] ALAGZ C,ALAGZ N,ZKAYA A,ELIK U,TURAN MF,YAZICI AT,et al.intravitreal bevacizumab in the treatment of choroidal neovascular membrane due to angioid streaks[J].Retina,2015,35(10):2001-2010.
[9] BATTAGLIA PARODI M,IACONO P,LA SPINA C,BERCHICCI L,SCOTTI F,LEYS A,et al.Intravitreal bevacizumab for nonsubfoveal choroidal neovascularization associated with angioid streaks[J].Am J Ophthalmol,2014,157(2):374-377.
[10] GIACOMELLI G,FINOCCHIO L,BIAGINI I,SODI A,MURRO V,INTROINI U,et al.Long-term follow-up of choroidal neovascularization due to angioid streaks with pro re nata intravitreal anti-VEGF treatment[J].Ophthalmologica,2017,238(1-2):44-51.
[11] FINGER RP,CHARBEL ISSA P,SCHMITZ-VALCKENBERG S,HOLZ FG,SCHOLL HN.Long-term effectiveness of intravitreal bevacizumab for choroidal neovascularization secondary to angioid streaks in pseudoxanthoma elasticum[J].Retina,2011,31(7):1268-1278.
[12] SAVASTANO MC,MINNELLA AM,ZINZANELLA G,FALSINI B,CAPOROSSI A.Successful long-term management of choroidal neovascularization secondary to angioid streaks in a patient with pseudoxanthoma elasticum:a case report[J].J Med Case Rep,2014,22(8):458.

相似文献/References:

[1]王楠叶,游志鹏,李国栋,等.玻璃体切割联合视网膜睫状体光凝术与内窥镜睫状体光凝术治疗新生血管性青光眼疗效对比[J].眼科新进展,2020,40(10):977.[doi:10.13389/j.cnki.rao.2020.0219]
 WANG Nanye,YOU Zhipeng,LI Guodong,et al.Comparison of the clinical efficacy of vitrectomy combined with retinal laser and cyclophotocoagulationand endoscopic cyclophotocoagulation in neovascular glaucoma[J].Recent Advances in Ophthalmology,2020,40(10):977.[doi:10.13389/j.cnki.rao.2020.0219]

备注/Memo

备注/Memo:
云南省教育厅科学研究基金(编号:2015FB076);云南省科技厅-昆明医科大学应用基础研究联合资金(编号:2015C043Y);云南省卫生和计划生育委员会医学后备人才培养计划(编号:H-201636)
更新日期/Last Update: 2017-10-24