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頁籤選單縮合
題名 | Intravitreal Bevacizumab Alone or in Combination with Posterior Subtenon Injection of Triamcinolone in Treating Neovascular Age-Related Macular Degeneration=單獨玻璃體內注射癌思停或合併後筋膜下注射類固醇治療新生血管性老年性黃斑部退化 |
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作者姓名(中文) | 王嘉康; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 50:1 2011.04[民100.04] |
頁次 | 頁32-40 |
分類號 | 416.746 |
關鍵詞 | 玻璃體內注射; 後筋膜下注射; 癌思停; 類固醇; 新生血管性老年性黃斑部退化; Bevacizumab; Triamcinolone; Choroidal neovascularization; Age-related macular degeneration; |
語文 | 英文(English) |
中文摘要 | 目的:在於探討對於老年性黃斑部退化患者發生脈絡膜新生血管後,以玻璃體內注射癌思停及後筋膜下注射類固醇治療之短期成效。方法:自2008年1月至2010年1月,收集老年性黃斑部退化患者發生中央窩下脈絡膜新生血管,到院前並無任何治療。患眼共分兩組IVB組為眼內注射1.25 mg癌恩停(57隻眼),IVB/PST組為眼內注射1.25 mg癌思停併後筋膜下注射類固醇20 mg(33隻眼)。測量注射一次後,1、2、3、及6個月後,最佳矯正視力、中央窩厚度、及中央黃斑部體積之變化,並記錄併發症之發生,組內及組間之差異分別以方法統計之。結果:最佳矯正視力、中央窩厚度、及中央黃斑部體積在注射1、2、3個月後兩組皆顯著降低(p<0.05),但於6個月後並無顯著降低(p>0.05)。注射前及注射一次l、2、3、及6個月後,最佳矯正視力、中央窩厚度、及中央黃斑部體積在兩組間並無統計上之差別。在IVB組57隻眠中有2隻眼有大範圍之黃斑部下出血,發生玻璃體出血,需進一步以玻璃體切除術治療。並無其他眼部併發症。結論:玻璃體內注射癌思停,不論有無合併後筋膜下注射類固醇,於3個月內注射一次,治療新生血管性老年性黃斑部退化,都是相同有效。但增加後筋膜下注射類固醇並無增加治療效果,且玻璃體內注射癌思停仍有潛在之危險性。 |
英文摘要 | Purpose: To investigate the short-term tomographic efficacy of intravitreal bevacizumab (IVB) combined with posterior subtenon triamcinolone (PST) in patients with choroidal neovascularization (CNV) caused by age-related macular degeneration (ARMD)Methods: This is a retrospective, comparative, and nonrandomized study From January 2008 to January 2010, patients with subfoveal CNV caused by AMD without prior intervention were enrolled. The eyes were divided into two study arms: the IVB group, patients who received 1.25 mg of intravitreal bevacizumab (57 eyes); and the IVB/PST group, patients who received 1.25 mg of intravitreal bevacizumab and 20 mg of posterior subtenon triamcinolone (33 eyes). Primary outcome measures included change in best-corrected visual acuity (BCVA), central foveal thickness (CFT) of 1 mm and central macular volume (CMV) of 5-mm diameter determined by spectral-domain optic coherence tomography 1, 2, 3 and 6 months after one injection. Complications after the injections were recorded. The intra-group difference was compared using Wilcoxon sign-rank test, while the inter-group difference was compared using Wilcoxon rank-sum test.Results: CMV and CFT were significantly reduced, and BCVA improved 1, 2 and 3 months after injections in both groups (p<0.05), but there was no significant change 6 months after injections (p>0.05). There were no significant difference in baseline BCVA, CMV and CFT between the two groups. BCVA and tomographic measures 1, 2, 3 and 6 months following injections showed no significant difference between the two groups. In the IVB group, there were 2 eyes (2/57 , 3.5%) with large submacular hemorrhage complicated with vitreous hemorrhage and requiring vitrectomy. There were no eyes with elevated intraocular pressure, retinal pigment epithelial tears, retinal detachment, and infectious endophthalmitis in either group.Conclusions: Both regimens (IV8 and IV8/PST) were useful in treating neovascular ARMD within 3 months by single injection. There was no additive effect contributed by posterior subtenon triamcinolone to intravitreal bevacizumab. Potential complications should be addressed after intravitreal bevacizumab injection |
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