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find Keyword "血管生成抑制剂/治疗应用" 83 results
  • 新一代抗血管内皮生长因子药物阿柏西普基础及临床研究现状

    血管内皮生长因子(VEGF)是新生血管性及血管性眼底疾病的重要治疗靶点。阿柏西普(Aflibercept,眼用制药VEGF Trap-Eye,商品名Eylea)是继哌加他尼钠(Pegaptanib,商品名Macugen)、雷珠单抗(Ranibizumab,商品名Lucentis)之后的新一代抗VEGF药物,可直接或间接作用于VEGF家族所有成员,减少新生血管形成,降低血管通透性。VEGF Trap-Eye尤与VEGF-A亲和力高,作用时间持久,在临床前实验中展现出较好的抗新生血管作用和降低血管通透性作用;玻璃体腔注射治疗老年性黄斑变性可取得与Ranibizumab相似的疗效,且延长注射间隔并不降低疗效;治疗糖尿病黄斑水肿疗效明显优于激光光凝治疗,且不同给药间隔可取得相似疗效;在提高视网膜静脉阻塞患者视力和减轻水肿方面亦有一定作用。用于治疗病理性近视继发脉络膜新生血管等其他疾病的疗效尚在临床观察中。VEGF Trap-Eye治疗新生血管性及血管性眼底疾病要进一步全面评价有效性和安全性还需要进行更长期的临床观察。

    Release date:2016-09-02 05:21 Export PDF Favorites Scan
  • Intravitreal injection of ranibizumab and combined treatment for severe Coats disease

    ObjectiveTo observe the efficacy of intravitreal injection of ranibizumab (IVR) and combined treatment for severe Coats disease. MethodsNineteen Coats disease patients (24 eyes) were enrolled in this retrospective non-comparative interventional clinical study. The patients included 17 males and 2 females. The age was ranged from 1 to 42 years old, with an average of (13.05±6.78) years. The patients included 15 children (age ≤14 years old) and 4 adults (age ≥18 years old). There were 13 patients with 3a stage and 6 patients with 3b stage. The treatment methods including IVR only, IVR combined with cryotherapy, IVR combined with cryotherapy and sclerotomy to drain subretinal fluid, IVR combined with vitrectomy. Treatments were repeated if it was necessary at the first day, the first week and the first month after injection. The interval between treatments was ≥1 month. Eleven patients (57.9%) underwent one treatment, 3 patients (15.8%) underwent 2 treatments, 3 patients (15.8%) underwent 3 treatments, 2 patients (10.5%) underwent 4 treatments. The treatment frequency including 22 times of IVR only, 6 times of IVR combined with cryotherapy, 5 times of IVR combined with cryotherapy and sclerotomy to drain subretinal fluid, 1 time of IVR combined with vitrectomy. The follow-up period was ranged from 6 to 36 months, with an average of (19.11±7.05) months. Visual acuity, retinal reattachment and ocular adverse events were observed. ResultsThree children (15.8%) were failing to test the visual acuity. Visual acuity was improved in 2 patients (10.5%), stable in 13 patients (68.4%) and decreased in 1 patient (5.3%). Three patients (15.8%) achieved totally retinal reattachment after treatment, while 16 patients (84.2%) achieved partially retinal reattachment. One patient had vitreous hemorrhage. One patient had neovascular glaucoma. ConclusionIVR and combined treatment were effective for severe Coats disease.

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  • Intravitreal injection of ranibizumab for retinal angiomatous proliferation

    ObjectiveTo observe the efficacy of intravitreal injection of ranibizumab (IVR) for retinal angiomatous proliferation (RAP). MethodsEleven patients (14 eyes) with RAP were enrolled in this retrospective clinical study. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), and maximum retinal thickness (MRT) were detected by examination of visual acuity and optical coherence tomography (OCT). The average BCVA was 0.17±0.21, CRT was (382.71±219.07) μm, MRT was (746.36±268.29) μm. All eyes received 0.5 mg (0.05 ml) ranibizumab injection. Follow-up visits were performed monthly after injection. The mean follow-up time was (15.38±13.64) month. Injections were repeated if the eyes with retinal edema. The mean number of repetitive IVR was (3.7±1.0) times/eye (from 1 to 10 times). Changes in BCVA, CRT, MRT and complications were observed at the last follow up. ResultsAt the last follow-up, the mean BCVA was 0.28±0.26 (from 0.01 to 1.0). Of 14 eyes, visual acuity improved in 11 eyes, not changed in 2 eyes and decreased in 1 eye. The difference of BCVA was significant between before and after the treatment (t=3.167,P=0.007). The mean CRT was (166.14±52.79) μm, which was less than that of pre-treatment values (t=3.737,P=0.002). The mean MRT was (360.43±102.19) μm, which was less than that of pre-treatment values (t=6.106,P=0.000). No ocular or systemic adverse effects occurred. ConclusionIVR is an efficient and safe treatment for RAP, with visual acuity improvement, decrease of CRT and MRT.

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  • Concentration of the inflammatory cytokines in vitreous of severe proliferative diabetic retinopathy after intravitreal ranibizumab injection

    ObjectiveTo observe the concentration of the inflammatory cytokines in vitreous of severe proliferative diabetic retinopathy (PDR) after intravitreal ranibizumab injection (IVR). MethodsA total of 80 PDR patients (80 eyes) were enrolled in this study. The patients were randomly divided into vitrectomy group (group A) and IVR combined with vitrectomy group (group B), 40 eyes in each group. The differences of sex (χ2=0.05), age (t=0.59), duration of diabetes (t=0.36), HbA1c (t=0.13) and intraocular pressure (F=0.81) between two groups were not significant (P>0.05). The eyes in group B received 0.5 mg (0.05 ml) ranibizumab injection at 7 days before operation. The vitreous samples (0.4 ml) were obtained before operation. The concentration of vascular endothelial growth factor (VEGF), interleukin (IL)-6, IL-8, intercellular adhesion molecule-1 (ICAM-1) and connective tissue growth factor (CTGF) were measured by enzyme-linked immunosorbent assays. ResultsThe concentration of VEGF and ICAM-1 were (10.70±3.60), (224.64±90.32) pg/L in group B and (72.38±23.59), (665.61±203.34) pg/L in group A. The differences of VEGF and ICAM-1 concentration between two groups was significant (t=16.34, 12.53; P<0.001). The concentration of IL-6 and IL-8 were (210.64±80.27), (156.00±57.74) pg/L in group B and (45.78±33.82), (41.07±13.82) pg/L in group A. The differences of IL-6 and IL-8 concentration between two groups was significant (t=11.97, 12.24; P<0.001). There was no difference of CTGF concentration between two groups (t=1.39, P=0.17). The CTGF/VEGF in group B was higher than that in group A (t=14.75, P<0.001). ConclusionsOne week after IVR, the concentration of VEGF and ICAM-1 are decreased, while IL-6 and IL-8 increased. There is no obvious change in CTGF, but CTGF/VEGF is increased.

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  • Meta-analysis of the effect of intravitreal bevacizumab versus photodynamic therapy in myopic choroidal neovascularisation

    ObjectiveTo further compare the effect of intravitreal injection of bevacizumab (IVB) and photodynamic therapy (PDT) for the treatment of choroidal neovascularization (CNV) secondary to pathologic myopia by meta-analysis. MethodsPertinent publications were identified through systemic searches of PubMed, EMBASE and the Cochrance Controlled Trials Register. All clinical comparative studies of IVB or PDT as initial treatment for CNV secondary to pathologic myopia were included. Meta analysis of these clinical trials was performed to analyze the effect of IVB and PDT for CNV secondary to pathologic myopia. Measurements included best corrected visual acuity (BCVA) and central foveal thickness (CFT). ResultsA total of 6 comparative studies involving 351 eyes were included. There were 196 eyes in IVB group and 215 eyes in PDT group. Funnel plots, Egger linear regression and Begg method did not show publication bias. Compared with PDT group, at 3, 6 and 12 months after IVB treatment, BCVA significantly increased . However, change of CFT at 3, 6 and 12 months did not vary significantly between IVB group and PDT group (3 months: WMD=-22.49, 95% CI=-93.49 to 48.52, P=0.53; 6 months: WMD=-17.34, 95% CI=-56.00 to 21.31, P=0.38; 12 months: WMD=-5.32, 95% CI=-56.37 to 45.74, P=0.84). ConclusionPatients with CNV secondary to pathologic myopia experienced a significant benefit of visual improvement after IVB, but reduction in CFT after the IVB or PDT did not vary significantly.

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  • Clinical observation of intravitreal injection of Conbercept treating exudative age-related macular degeneration

    ObjectiveTo observe the clinical efficiency of intravitreal Conbercept on exudative age-related macular degeneration (eAMD). MethodsThis is an open and prospective study without control trial. Twenty eyes from 20 patients (19 males and 1 female) with eAMD diagnosed by fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study. Before the injection, best-corrected visual acuity (BCVA) of early treatment of diabetic retinopathy study (ETDRS), non-contact tonometer, ophthalmoscope, fundus photography, fundus fluorescein angiograph (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were examined. The initial average letters of ETDRS acuity were 41.20±22.61, range from 8 to 80. The initial average central retina thickness (CRT) was (345.25±131.96) μm, range from 152 to 770 μm.All affected eyes were treated with intravitreal conbercept 0.05 ml (10 mg/ml). The patients were followed up for 6 to 9 months, with the mean time of (7.35±0.99) months.The BCVA, CRT after treatment were compared with baseline using paired t-test. ResultsDuring the 1, 3, 6, 12 months after treatment and the latest follow up, the mean BCVA were all improved with statistically significant difference (t=5.85, 7.09, 7.44, 7.25; P < 0.05). At 1 month ater treatment, the mean BCVA was obviously improved in 6 eyes (30%), improved in 8 eyes (40%), stable in 6 eyes (30%). At latest follow up, the mean BCVA was obviously improved in 6 eyes (30%), improved in 9 eyes (45%), stable in 5 eyes (25%). During the 1, 3, 6, 12 months after treatment and the latest follow up, the mean CRT were all decreased with statistically significant difference (t=3.34, 3.78, 3.47, 3.44; P < 0.05). At latest follow up, the leakage in macula lutea disappeared in 6 eyes (30%), decreased in 11 eyes (55%) and increased in 3 eyes (15%). No adverse events such as secondary retinal detachment or endoophthalmitis were found during the follow-up duration. ConclusionIntravitreal conbercept is a safe and effective approach for eAMD, may improve visual acuity, exudation and macular edema.

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  • Outcomes of adjuvant intravitreal anti-vascular endothelial growth factor therapy in advanced Coats disease

    ObjectiveTo observe the efficacy of adjuvant intravitreal injection of anti-vascular endothelial growth factor (VEGF) therapy for advanced Coats disease. MethodsThis study is a retrospective case series study. Fourteen patients (14 eyes), presenting Coats Stages 3B and 4 (8 and 6 eyes, respectively) were enrolled. All the patients were treated with adjuvant intravitreal anti-VEGF therapy. The intravitreal anti-VEGF injections varied from 1 to 7, with a median injections of 2.14. In 14 eyes, combined therapy was subretinal fluid drainage in 4 eyes, photocoagulation in 2 eyes, vitrectomy in 8 eyes. The follow-up period was ranged from 4 to 36 months, with a median follow-up of 18.8 months. Visual acuity and retinal reattachment were observed in follow up. ResultsAt last follow up, global suvival was 100.0% with no enucleation performed in any patient because of disease progression. Except for 2 children who were unable to cope with the visual acuity test, visual acuity was improved in 2 patients, stable in 8 patients, and decreased in 2 patients. 5 patients (35.7%) achieved in complete retinal reattachment, 3 patients (21.4%) were succeed in partial retinal reattachment, and the remain 6 patients(42.8%) failed in retinal reattachment. Two patients developed cataract after vitrectomy, and no other adverse reaction was observed during follow-up. ConclusionAnti-VEGF therapy combined with classic treatments in advanced Coats disease can keep or impove the visual acuity in most patients by reducing of subretinal exudation.

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  • 玻璃体腔注射雷珠单抗治疗脉络膜骨瘤继发脉络膜新生血管一例

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  • 影响渗出型老年性黄斑变性患者玻璃体腔注射雷珠单抗治疗反应的临床特征与基因因素

    玻璃体腔注射雷珠单抗可减少渗出型老年性黄斑变性(wAMD)患者的脉络膜新生血管(CNV)生成,稳定或改善视力。随着临床应用研究的逐渐深入,发现并非所有wAMD患者对玻璃体腔注射雷珠单抗均表现出良好的治疗效果。研究发现,患者基线视力、CNV病灶大小及类型、年龄、玻璃体视网膜黏附状态、疾病的基因特征等均可影响患者对治疗的反应。充分了解影响wAMD患者雷珠单抗治疗反应的相关因素,增强玻璃体腔注射雷珠单抗治疗的针对性,提高其临床应用效果具有重要意义。

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  • 抗血管内皮生长因子药物治疗皮肤色素失禁症相关性视网膜病变一例

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