摘要
【目的】分析38例经玻璃体腔注射贝伐单抗治疗的视网膜中央静脉阻塞黄斑水肿(CRVO-ME)患者的临床特征,评估并筛选对患者最终视力恢复有预测意义的因素。【方法】38例CRVO-ME患者,采用玻璃体腔注射25 g/L的贝伐单抗0.05 mL,必要时重复治疗,随访12个月。根据12月时视力恢复水平,将患者分为两组:W组(24例)为视力恢复良好组(Well-gainer);P组(14例)为视力恢复不良组(Poor-gainer)。分析两组患者的年龄、病程、基线视力、光学相干断层扫描特征(OCT)和荧光血管造影(FFA)特征。【结果】P组患者治疗前存在黄斑缺血者比W组多见(W组:11/24,45.8%;P组:11/14,78.6%;P=0.049)。W组患者平均年龄比P组患者小(W组:51.21±11.69;P组:57.50±6.76;P=0.043),治疗前最佳矫正视力(BCVA)差(W组:1.40±0.59;P组:1.03±0.46;P=0.041),首次注射后1月视力提高大于4行Snellen视力表的患者比率高(W组:83.3%,20/24;P组:14.3%,2/14;P<0.001)。首次注射后1月视力提高与最终视力呈正相关(r=0.624,P<0.001)。中央黄斑厚度下降程度与视力改善程度之间无相关性(r=0.269,P=0.193)。【结论】年龄、基线最佳矫正视力、黄斑缺血等因素可能是影响最终视力恢复的有意义的预测因子。治疗前视力较低的年轻患者最终视力恢复较理想,治疗前即已有黄斑缺血的患者往往最终视力恢复欠佳。首次注射后1月时视力恢复程度对最终视力有预测价值。对CRVO-ME患者行抗血管内皮生长因子(VEGF)治疗,需慎重评估,做好解释沟通工作,讲明重复治疗的可能和最终的视力预后。
[Objective]To evaluate predictive factors for final visual outcomes after intravitreal bevacizumab injections in 38 patients with macular edema secondary to CRVO. [Method] Thirty-eight patients with ME due to CRVO and treated with intravitreal 0.05 mL 25g/L bevacizumab on an as-needed basis with follow-up of 12 months were reviewed. Patients were divided into two groups according to the final visual gain ： Group W （ ＂well-gainer＂ ） and Group P （ ＂Poor-gainer＂ ）. Group W and Group P contains 24 and 14 patients respectively. Comparative demographic, duration, baseline VA, OCT and FFA characteristics between the two groups were analyzed. [Result] Macular ischemia at baseline was more frequent in Group P than Group W （Group W： 45.8%, 11/24; Group P： 78.6%, 11/14; P = 0.049）. ＂Well-gainers＂ in Group W were younger （Group W： 51.21 ± 11.69; Group P： 57.50 ± 6.76; P = 0.043） and had a relatively lower baseline VA than ＂Poor-gainers＂ in Group P （Group W： 1.40 ± 0.59; Group P： 1.03 ±0.46; P = 0.041 ）. There were more ＂early gainers＂, whose BCVA improved 4 lines of Snellen after the initial bevacizumab therapy, in Group W （Group W： 83.3%, 20/24; Group P： 14.3%, 2/14; P 〈 0.001）. VA gain 1 month after initial injection was significantly associated with a better final VA improvement （r = 0.624,P 〈 0.001 ）. No correlations were observed between CMT resolution and final VA
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2012年第1期79-84,共6页
Journal of Sun Yat-Sen University:Medical Sciences
基金
国家自然科学基金青年科学基金项目(81100685)
