The Therapeutic Effects of Bevacizumab in Patients with Polypoidal Choroidal Vasculopathy
2
조회
0
다운로드
9
인용
0
참고문헌
키워드
초록
Purpose: To evaluate the efficacy and safety of intravitreal bevacizumab for polypoidal choroidal vasculopathy (PCV). Methods: In this retrospective interventional pilot study, 12 eyes of 11 patients with active PCV were treated with intravitreal bevacizumab (1.25 mg) alone or in combination with photodynamic therapy (PDT) depending on the informed patient’s choice. Intravitreal bevacizumab was repeated at 6-week intervals until the regression of active lesion was detected on fluorescein angiography (FA) which was done on a regular basis, Indocyanine green angiography (ICGA) and optical coherence tomography (OCT) analyses. Results: Intravitreal bevacizumab was given alone in 8 eyes (Group 1) and in combination with PDT in 4 eyes (Group 2). Mean follow-up duration was 17 weeks in group 1 and 15 weeks in group 2 after bevacizumab treatment. The mean number of bevacizumab injections was 2.2 in group 1 and 2.5 in group 2. Mean BCVA improved from 20/63 to 20/40 in group 1 and 20/63 to 20/32 in group 2. Of all eyes, the BCVA improved by ≥2 lines in seven (58%) eyes and resolution of fluid and hemorrhages in clinical examination, an absence of leakage on repeat FAs, or resolved pigment epithelial detachment (PED) and/or subretinal fluid (SRF) on OCT exam was confirmed in 10 (83%) eyes. Partial or complete regression of the polypoidal vessels and interconnecting vessels was reported for most cases at the last follow-up. No significant ocular or systemic side effects were observed in both groups. Conclusions: Short-term results indicate that intravitreal bevacizumab (1.25 mg) alone or in combination with PDT is well tolerated and associated with improvement in BCVA and reduced angiographic leakage in most patients. Further evaluation of intravitreal bevacizumab therapy for the treatment of PCV is warranted.
Abstract
Purpose: To evaluate the efficacy and safety of intravitreal bevacizumab for polypoidal choroidal vasculopathy (PCV). Methods: In this retrospective interventional pilot study, 12 eyes of 11 patients with active PCV were treated with intravitreal bevacizumab (1.25 mg) alone or in combination with photodynamic therapy (PDT) depending on the informed patient’s choice. Intravitreal bevacizumab was repeated at 6-week intervals until the regression of active lesion was detected on fluorescein angiography (FA) which was done on a regular basis, Indocyanine green angiography (ICGA) and optical coherence tomography (OCT) analyses. Results: Intravitreal bevacizumab was given alone in 8 eyes (Group 1) and in combination with PDT in 4 eyes (Group 2). Mean follow-up duration was 17 weeks in group 1 and 15 weeks in group 2 after bevacizumab treatment. The mean number of bevacizumab injections was 2.2 in group 1 and 2.5 in group 2. Mean BCVA improved from 20/63 to 20/40 in group 1 and 20/63 to 20/32 in group 2. Of all eyes, the BCVA improved by ≥2 lines in seven (58%) eyes and resolution of fluid and hemorrhages in clinical examination, an absence of leakage on repeat FAs, or resolved pigment epithelial detachment (PED) and/or subretinal fluid (SRF) on OCT exam was confirmed in 10 (83%) eyes. Partial or complete regression of the polypoidal vessels and interconnecting vessels was reported for most cases at the last follow-up. No significant ocular or systemic side effects were observed in both groups. Conclusions: Short-term results indicate that intravitreal bevacizumab (1.25 mg) alone or in combination with PDT is well tolerated and associated with improvement in BCVA and reduced angiographic leakage in most patients. Further evaluation of intravitreal bevacizumab therapy for the treatment of PCV is warranted.
참고문헌 (32)
- Yannuzzi LA, "Idiopathic polypoidal choroidal vasculopathy (IPCV)", Retina, 10, pp.1~8 (1990)
- Spaide RF, "Indocyanine green videoangiography of idiopathic polypoidal choroidal vasculopathy", Retina, 15, pp.100~10 (1995)
- Yannuzzi LA, "Polypoidal choroidal vasculopathy and neovascularized age‐related macular degeneration", Arch Ophthalmol, 117, pp.1503~10 (1999)
- Uyama M, "Idiopathic polypoidal choroidal vasculopathy in Japanese patients", Arch Ophthalmol, 117, pp.1035~42 (1999)
- Moorthy RS, "Idiopathic polypoidal choroidal vasculopathy of the macula", Ophthalmology, 105, pp.1380~5 (1998)
- Yannuzzi LA, "The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy", Arch Ophthal, 115, pp.478~85 (1997)
- Uyama M, "Polypoidal choroidal vasculopathy: natural history", Am J Ophthalmol, 133, pp.639~48 (2002)
- Yuzawa M, "A study of laser photocoagulation for polypoidal choroidal vasculopathy", Jpn J Ophthalmol, 47, pp.379~84 (2003)
- Hattenbach LO, "Intravitreous injection of tissue plasminogen activator and gas in the treatment of submacular hemorrhage under various conditions", Ophthalmology, 108, pp.1458~92 (2001)
- Shirage F, "Surgical treatment of submacular hemorrhage associated with idiopathic polypoidal choroidal vasculopathy", Am J Ophthalmol, 128, pp.147~54 (1999)
- Terasaki H, "Polypoidal choroidal vasculopathy treated with macular translocation: clinical pathological correlation", Br J Ophthalmol, 86, pp.321~7 (2002)
- Spaide RF, "Treatment of polypoidal choroidal vasculopathy with photodynamic therapy", Retina, 22, pp.529~35 (2002)
- Chan WM, "Photodynamic therapy with verteporfin for symptomatic polypoidal choroidal vasculopathy: one‐year results of a prospective case series", Ophthalmology, 111, pp.1576~84 (2004)
- Ojima Y, "Recurrent bleeding after photodynamic therapy in polypoidal choroidal vasculopathy", Am J Ophthalmol, 141, pp.958~60 (2006)
- 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.331~5 (2005)
- Avery RL, "Intravitreal bevacizumab (Avastin) for neovascular age‐related macular degeneration", Ophthalmology, 113, pp.363~72 (2006)
- Spaide RF, "Intravitreal bevacizumab treatment of choroidal neovascularization secondary to age‐related macular degeneration", Retina, 26, pp.383~90 (2006)
- Nguyen QD, "Bevacizumab suppresses choroidal neovascularizsation caused by pathological myopia", Br J Ophthalmol, 89, pp.1368~70 (2005)
- Tong JP, "Aqueous humor levels of vascular endothelial growth factor and pigment epithelium‐derived factor in polypoidal choroidal vasculopathy and choroidal neovascularization", Am J Ophthalmol, 141, pp.456~62 (2006)
- Matsuoka M, "Expression of pigment epithelium derived factor and vascular endothelial growth factor in choroidal neovascular membranes and polypoidal choroidal vasculopathy", Br J Ophthalmol, 88, pp.809~15 (2004)
- Lafaut BA, "Polypoidal choroidal vasculopathy pattern in age‐related macular degeneration: a clinicopathologic correlation", Retina, 20, pp.650~4 (2000)
- VEGF inhibition study in ocular neovascularization clinical trial group, "Chakravarthy U, Adamis AP, Cunningham ET Jr, et al. Year 2 efficacy results of 2 randomized controlled clinical trial of pegaptanib for neovascular age‐related macular degeneration", Ophthalmology, 113, pp.1508~25 (2006)
- Heier JS, "Ranibizumab for treatment of neovascular age‐related macular degeneration: a phase I", II multicenter, controlled, multidose study, 2006, pp.113, 642~4
- Mauget‐Faysse M, "Photodynamic therapy with verteporfin in the treatment of exudative idiopathic polypoidal choroidal vasculopathy", Eur J Ophthalmol, 16, pp.695~704 (2006)
- Lafaut BA, "Polypoidal choroidal vasculopathy in Caucasians", Grafes Arch Clin Exp Ophthalmol, 238, pp.752~9 (2000)
- Ciardella AP, "Polypoidal choroidal vasculopathy", Surv Ophthalmol, 49, pp.25~37 (2004)
- Tsujikawa A, "Pigment epithelial detachment in polypoidal choroidal vasculopathy", Am J Ophthalmol, 143, pp.102~11 (2007)
- Sho K, "Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics", Arch Ophthalmol, 121, pp.1392~6 (2003)
- Silva RM, "Polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin", Grafes Arch Clin Exp Ophthalmo, 243, pp.973~9 (2005)
- Lee SC, "Photodynamic therapy with verteporfin for polypoidal choroidal vasculopathy of the macula", Ophthalmologica, 218, pp.193~201 (2004)
- Chan WM, "Extensive submacular hemorrhage in polypoidal choroidal vasculopathy managed by sequential gas displacement and photodynamic therapy: a pilot study of one‐year follow up", Clin Exp Ophthalmol, 33, pp.611~8 (2005)
- Augustin AJ, "Verteporfin therapy combined with intravitreal triamcinolone in all types of choroidal neovascularization due to age‐related macular degeneration", Ophthalmology, 113, pp.14~22 (2006)