본문 바로가기
KERD
논문KCI 등재

Intravitreal Bevacizumab for Treatment of Diabetic Macular Edema

3

조회

0

다운로드

6

인용

0

참고문헌

키워드

주제분류안과학

초록

Purpose: To evaluate the effect of intravitreal bevacizumab on visual function and retinal thickness in patients with diabetic macular edema (DME). Methods: Thirty eyes of twenty-eight patients (mean age, 57.9±13.8 years) with DME were included in this study. Complete ophthalmic examination, including determination of best-corrected visual acuity (BCVA), stereoscopic biomicroscopy, and retinal thickness measurement by optical coherence tomography (OCT), was done at baseline and at each follow-up visit. All patients were treated with a 0.05 ㎖ intravitreal injection containing 1.25 ㎎ of bevacizumab. Results: All patients completed 3 months of follow-up with a mean follow-up period of 5.26±2.39 months. The mean BCVA at baseline was 0.73±0.36 logMAR, which significantly improved to 0.63±0.41 (p=0.02), 0.58±0.36 (p=0.003), and 0.61±0.40 logMAR (p=0.006) at 1 week, 1 month, and 3 months. Final BCVA analysis demonstrated that 15 eyes (50%) remained stable and 12 (40%) improved ≥2 lines on BCVA. The mean central retinal thickness was 498.96±123.99 ㎛ at baseline and decreased to 359.06±105.97 (p<0.001), 334.40±121.76 (p<0.001), 421.40±192.76 ㎛ (p=0.035) at 1 week, 1 month, and 3 months. No ocular toxicity or adverse effects were observed. Conclusions: Intravitreal bevacizumab injection resulted in significant improvement in BCVA and central retinal thickness as early as 1 week after injection in patients with DME, and this beneficial effect persisted for up to 3 months. However, the slight reduction in this improvement at 3 months suggests that repeated bevacizumab injections might be necessary. To evaluate the long-term safety and efficacy, further prospective randomized controlled clinical trials will be needed.

Abstract

Purpose: To evaluate the effect of intravitreal bevacizumab on visual function and retinal thickness in patients with diabetic macular edema (DME). Methods: Thirty eyes of twenty-eight patients (mean age, 57.9±13.8 years) with DME were included in this study. Complete ophthalmic examination, including determination of best-corrected visual acuity (BCVA), stereoscopic biomicroscopy, and retinal thickness measurement by optical coherence tomography (OCT), was done at baseline and at each follow-up visit. All patients were treated with a 0.05 ㎖ intravitreal injection containing 1.25 ㎎ of bevacizumab. Results: All patients completed 3 months of follow-up with a mean follow-up period of 5.26±2.39 months. The mean BCVA at baseline was 0.73±0.36 logMAR, which significantly improved to 0.63±0.41 (p=0.02), 0.58±0.36 (p=0.003), and 0.61±0.40 logMAR (p=0.006) at 1 week, 1 month, and 3 months. Final BCVA analysis demonstrated that 15 eyes (50%) remained stable and 12 (40%) improved ≥2 lines on BCVA. The mean central retinal thickness was 498.96±123.99 ㎛ at baseline and decreased to 359.06±105.97 (p<0.001), 334.40±121.76 (p<0.001), 421.40±192.76 ㎛ (p=0.035) at 1 week, 1 month, and 3 months. No ocular toxicity or adverse effects were observed. Conclusions: Intravitreal bevacizumab injection resulted in significant improvement in BCVA and central retinal thickness as early as 1 week after injection in patients with DME, and this beneficial effect persisted for up to 3 months. However, the slight reduction in this improvement at 3 months suggests that repeated bevacizumab injections might be necessary. To evaluate the long-term safety and efficacy, further prospective randomized controlled clinical trials will be needed.

참고문헌 (30)

  1. Ferris FL, "Macular edema: a complication of diabetic retinopathy", Surv Ophthalmol, 28, pp.452~461 (1984)
  2. Photocoagulation for diabetic macular edema, "Early Treatment Diabetic Retinopathy Study Report Number 1. Early Treatment Diabetic Retinopathy Study Research Group", Arch Ophthalmol, 103, pp.1796~1806 (1985)
  3. Jonas JB, "Intravitreal injection of triamcinolone for diffuse diabetic macular edema", Arch Ophthalmol, 121, pp.57~61 (2003)
  4. Martidis A, "Intravitreal triamcinolone for refractory diabetic macular edema", Am J Ophthalmol, 109, pp.920~927 (2002)
  5. Jonas JB, "Intraocular pressure after intravitreal injection of triamcinolone acetonide", Br J Ophthalmol, 87, pp.24~27 (2003)
  6. Patelli F, "Time course of changes in retinal thickness and visual acuity after intravitreal triamcinolone acetonide for diffuse diabetic macular edema with and without previous macular laser treatment", Retina, 26, pp.840~845 (2005)
  7. Qaum T, "VEGF-initiated blood-retinal barrier breakdown in early diabetes", Invest Ophthalmol Vis Sci, 42, pp.2408~2413 (2001)
  8. Aiello LP, "Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders", N Engl J Med, 331, pp.1480~1487 (1994)
  9. Adamis AP, "Increased vascular endothelial growth factor levels in the vitreous of eyes with proliferative diabetic retinopathy", Am J Ophthalmol, 118, pp.445~450 (1994)
  10. Funatsu H, "Increased levels of vascular endothelial growth factor and interleukin-6 in the aqueous humor of diabetics with macular edema", Am J Ophthalmol, 133, pp.70~77 (2002)
  11. Funatsu H, "Angiotensin II and vascular endothelial growth factor in the vitreous fluid of patients with diabetic macular edema and other retinal disorders", Am J Ophthalmol, 133, pp.537~543 (2002)
  12. Cunningham ET Jr, "A phase II randomized double-masked trial of pegaptanib, an anti-vascular endothelial growth factor aptamer, for diabetic macular edema", Ophthalmology, 112, pp.1747~1757 (2005)
  13. Ferrara N, "Discovery and development of bevacizumab, an anti-VEGF antibody for treating cancer", Nat Rev Drug Discov, 3, pp.391~400 (2004)
  14. Spaide RF, "Intravitreal bevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage", Retina, 26, pp.275~278 (2006)
  15. Michels S, "Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration. Twelve-week results of an uncontrolled open- label clinical study", Ophthalmology, 112, pp.1035~1047 (2005)
  16. Avery RL, "Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration", Ophthalmology, 113, pp.363~372 (2006)
  17. Iturralde D, "Intravitreal bevacizumab (Avastin) treatment of macular edema in central retinal vein occlusion: a short-term study", Retina, 26, pp.279~284 (2006)
  18. "The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulindependent diabetes mellitus. Diabetes Control and Complications Trial Research Group", N Engl J Med, 329, pp.977~986 (1993)
  19. UK Prospective Diabetes Study Group, "Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38", BMJ, 317, pp.703~713 (1998)
  20. Strom C, "Effect of ruboxistaurin on blood-retinal barrier permeability in relation to severity of leakage in diabetic macular edema", Invest Ophthalmol Vis Sci, 46, pp.3855~3858 (2005)
  21. Campochiaro PA, "C99-PKC412-003 Study Group. Reduction of diabetic macular edema by oral administration of the kinase inhibitor PKC412", Invest Ophthalmol Vis Sci, 45, pp.922~931 (2004)
  22. Ferrara N, "Vascular endothelial growth factor: basic science and clinical progress", Endocr Rev, 25, pp.581~611 (2004)
  23. Mordenti J, "Intraocular pharmacokinetics and safety of a humanized monoclonal antibody in rabbits after intravitreal administration of a solution or a PLGA microsphere formulation", Toxicol Sci, 52, pp.101~106 (1999)
  24. Shahar JS, "Electrophysiologic and retinal penetration studies following intravitreal injection of bevacizumab", Retina, 26, pp.262~269 (2006)
  25. Maturi RK, "Electrophysiologic findings after intravitreal bevacizumab (Avastin) treatment", Retina, 26, pp.270~274 (2006)
  26. Manzano RP, "Testing intravitreal toxicity of bevacizumab (Avastin)", Retina, 26, pp.257~261 (2006)
  27. Rosenfeld PJ, "Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for neovascular age-related macular degeneration", Ophthalmic Surg Lasers Imaging, 36, pp.331~335 (2005)
  28. Haritoglou C, "Intravitreal bevacizumab (Avastin) therapy for persistent diffuse diabetic macular edema", Retina, 26, pp.999~1005 (2006)
  29. Arevalo JF, "Primary intravitreal bevacizumab (Avastin) for diabetic macular edema", Ophthalmology, 114, pp.743~750 (2007)
  30. Yanyali A, "Bevacizumab (Avastin) for diabetic macular edema in previously vitrectomized eyes", Am J Ophthalmol, 144, pp.124~126 (2007)

관련 논문AI추천

Intravitreal Bevacizumab Alone versus Combined with Macular Photocoagulation in Diabetic Macular Edema문연성, Ei Tae Kim, Soo Jeong Lee대한안과학회 · Korean Journal of Ophthalmology2011 · 제25권 제5호Comparison of the Short-Term Effects of Intravitreal Triamcinolone Acetonide and Bevacizumab Injection for Diabetic Macular Edema이상준, Ju Hwan Song, Jung Joo Lee대한안과학회 · Korean Journal of Ophthalmology2011 · 제25권 제3호당뇨황반부종에서 안내 베바시주맙 치료 후 빛간섭단층촬영을 이용한 망막 혈관 직경의 변화김성수, 김영준, 김형은, 송원경대한안과학회 · 대한안과학회지2012 · 제53권 제2호Prospective Clinical Trial of Intravitreal Aflibercept Treat-and-extend Regimen for Diabetic Macular Edema: 1-Year OutcomesChie Sotozono, Hiroki Mieno, Kazuhito Yoneda, Kengo Yoshii, Kenji Nagata, Kentaro Kojima, Nobuhiro Terao대한안과학회 · Korean Journal of Ophthalmology2020 · 제34권 제4호Efficacy of Intravitreal Anti-vascular Endothelial Growth Factor or Steroid Injection in Diabetic Macular Edema According to Fluid Turbidity in Optical Coherence Tomography박영숙, 손준홍, 이경민, 정희영대한안과학회 · Korean Journal of Ophthalmology2014 · 제28권 제4호Switching to Aflibercept in Diabetic Macular Edema after Unsatisfactory Response to Other Anti-vascular Endothelial Growth Factor DrugsAhmed H. Aldoghaimy, Mahmoud F. Rateb, Mohamed G. Saleh, Walid S. Ibrahim, Zeiad H. Eldaly대한안과학회 · Korean Journal of Ophthalmology2019 · 제33권 제2호

이 간행물의 다른 논문 (14건)