中山大学学报（医学科学版）2012，Vol.33Issue(1)：79-84,6.
贝伐单抗治疗视网膜中央静脉阻塞黄斑水肿后视力恢复的预测因素分析
Prognostic Factors for Visual Outcome after Intravitreal Bevacizumab for Macular Edema Due to Central Retinal Vein Occlusion
摘要
Abstract
[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 VAimprovement. [Conclusion] Age, baseline BCVA and macular ischemia are the most important predictive factors of the final visual gain after anti-VEGF therapy in Patients with CRVO-ME. Younger patients with low baseline VA are most likely to benefit from bevacizumab treatment. Pre-existing macular ischemia is a strong negative prognostic factor of final visual improvement. Patients who show immediate marked improvement at the first month will likely have a better visual outcome. It would be prudent to weigh that factor especially when considering anti-VEGF therapies for CRVO patients with ischemia macula.关键词
视网膜中央静脉阻塞/黄斑水肿/贝伐单抗/预测因子Key words
retinal central vein occlusion/ macular edema/ bevacizumab/ predictive factor分类
医药卫生引用本文复制引用
丁小燕,李加青,于珊珊,吴斌斌,曾婧,刘冉,潘间英,唐仕波..贝伐单抗治疗视网膜中央静脉阻塞黄斑水肿后视力恢复的预测因素分析[J].中山大学学报（医学科学版）,2012,33(1):79-84,6.基金项目
国家自然科学基金青年科学基金项目(81100685) （81100685）
