摘要
目的 总结分析玻璃体腔注射抗血管内皮生长因子（VEGF）药物治疗年龄相关性黄斑变性（AMD）引起的视网膜色素上皮（RPE）撕裂的临床特点.方法 文献分析.通过PubMed和中国生物医学文献光盘数据库检索系统查阅玻璃体腔注射抗VEGF药物治疗AMD引起RPE撕裂的相关文献,统计分析患者的年龄、视力、RPE撕裂的发生率及发生部位、发生RPE撕裂前玻璃体腔注药的次数及周期、玻璃体腔注射的药物种类、撕裂发生的危险因素等.结果 最终有35篇文献（7879眼）纳入研究.发生RPE撕裂的患者的平均年龄为78.6岁（59～96岁）,平均玻璃体腔注药1.6次（1～次）,撕裂发生后至初次诊断的平均时间间隔为34.8 d（1 d～4个月）.玻璃体腔注射任何抗VEGF药物均可能会引起RPE的撕裂,RPE撕裂基本都发生在平行于色素上皮脱离（PED）的边缘.玻璃体腔注药引起RPE撕裂的发生率为0.1%～7.5%,平均1.9%.初次确诊为RPE撕裂时,与撕裂发生前相比,绝大多数患者的视力有提高或保持稳定（81.4%）.经过平均94.9 d的随访,绝大多数患者的最终视力保持稳定或有提高（83.3%）.大范围的血管性PED是RPE撕裂发生的危险因素,当血管性PED的高度＞400μm时,玻璃体腔注药后发生RPE撕裂的危险性明显增加.结论 玻璃体腔注射抗VEGF药物治疗AMD可能会引起RPE的撕裂,但发生率较低,且RPE撕裂对大多数患者的视力无明显影响.大范围的、高的血管性PED是RPE撕裂发生的危险因素.
Objective To analyze the characteristics of retinal pigment epithelium （RPE） tears following the injection of intravitreal anti-vascular endothelial growth factor （VEGF） for the treatment of age-related macular degeneration （AMD）. Methods A comprehensive literature review of RPE tears following anti-VEGF therapy for AMD was conducted using the PubMed and CBM disc databases, and the features of RPE tears were summarized. Results A total of 35 studies from the literature were included. The average age of patients who developed RPE tears was 78.6 years （range 59-96 years）, and the average injection times before tears developed was 1.6 （range 1-4）. The mean duration time between the first injection and diagnosis was 34.8 d （range 1 d-4 months）. Despite the development of RPE tears, anti-VEGF therapy can still inhibit choroidal neovascularization. Compared to visual acuity before injection, most patients had better or stable visual acuity （81.4%） even with the development of RPE tears. With an average follow-up of 94.9 days, most patients had stable or better visual acuity （83.3%）. Conclusion Although anti-VEGF therapy for AMD may induce RPE tearing, this complication does not predominantly affect vision. Large-size pigment epithelial detachment （PED） is a risk factor for RPE tears, especially with large or high vascular PED.
出处
《中华眼视光学与视觉科学杂志》
CAS
2010年第5期378-381,共4页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
血管内皮生长因子
玻璃体腔注药
黄斑变性
年龄相关性
色素上皮
眼
撕裂
Vascular endothelial growth factor
Intravitreal injection
Macular degeneration,age-related
Retinal pigment epithelium,eye
Tearing
