钱 彤 黎晓新 尹 虹 梁建宏 齐慧君

Intravitreous bevacizumab(Avastin)therapy for diffuse diabetic
macular edema
Qian Tong，Li Xiaoxin，Yin Hong，Liang Jianhong，Qi Huijun．Department of Ophthalmolog) 。Peking University
People’ Hospital，Beqing 100044，China

Abstract Objective Retinal phot0coagulation is beneficial for improving the visual acuity in the patients with macularedema，but its outcome is not satisfied for difuse maeular edema．This study was to evaluate the eficacv of bevacizumab(AvastinOil diffuse diabetic macular edema． Methods The clinical data of 68 eyes(57 patients)with difluse macular edema received
intravitreous injection of 1．25 ing(0．05 mL)bevacizumab(Avastinwereretrospectivelyanalyzed．The best corrected visualacuity(BCVA)，slit—lamp examination，intraocularpressure nleasnrement and stereoscopic bionficroseopy examination were carriedout before injection and at 1 day，2 days，3 days，3 weeks，6 weeks and 1 2 weeks after initial injection．Optical coherencetomography(OCT)was performed prior to injection and 3，6，12 weeks after initial injection．Fundus photography，fluorescein~ndus angiography(FFA)were performed prior to injection and 6，12 weeks after initial injection．The follow．up period was 2—19 months．The changes of BCVA and central inaeular thickness(CMT)of all the eyes wereevaluated before and after theinjeetion． Results The BCVA was improved in 29 eyes(42．6％ )，stable in 35 e?es(5 1．5％ )and decreased in 4 eyes(5．9％ )during the follow—up．The nlean central maeular thickness was(506．19 4-1 53．78) m in preinjection and(379．10±166．32) m in postinjection，showing a statistically significant difference between them(t=4．719，P=0．000)．No significant change in IOP and cataract progression were observed．No adverse events of ocu]ar or systemic tissue occurred． ConclusionThe intravitreal injection of bevacizumab(Avastin)can relieve diffuse nlaeular edema and damage of visual function．

Key words bevacizumab(Avastin)；diabetic retinopathy；nlacular edema

摘要 目的评估玻璃体腔注射贝伐单抗bevacizumab(Avastin)治疗糖尿病性黄斑水肿(DME)的疗效。方法 回顾分析接受玻璃体腔注射Avastin治疗DME的患者57例(68眼)，所有患者均接受玻璃体腔内注射Avastin 1．25 mg (0．05 mE)。治疗前及治疗后1、2、3 d，3、6、12周进行最佳矫正视力(BCVA)、眼压、裂隙灯及间接检眼镜检查。治疗前及治疗后3、6、12周行光学相干断层扫描(OCT)检查。治疗前及治疗后6周、12周行彩色眼底照相、荧光素眼底血管造影(FFA)检查。有21、13、2眼分别需要注射2、3、4次。随访时间2～19个月，平均(3．10 4- _1．62)个月。对比分析治疗前后患者视力及黄斑中心视网膜厚度(CMT)的改变。结果治疗后患者视力明显提高，CMT平均值治疗前为(506．19±153．78) m，治疗后3、6、12周时均明显减低(t=3．45，3．18，3．46，P<0．05)，治疗后末次随诊时为(379．10±166．32) m，与术前相比差异有统计学意义(t=4．719，P：0．000)。随访中未见眼压异常改变及白内障的进展，未见与药物有关的眼部和全身不良反应。结论玻璃体腔注射Avastin后，黄斑水肿明显减轻，视力稳定并提高，必要时需要连续注射治疗，长期效果需进一步观察。

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