Лечение ретинопатии Бевацизумабом ?

[Gratis]

Коллеги, не пинайте если вопрос покажется наивным, я ни разу не офтальмолог.

Имеются ли в России (и СНГ) работы по применению Бевацизумаба при ретинопатии недоношенных?

Источник вдохновения: [Ссылки доступны только зарегистрированным пользователям ]

И как Вы (офтальмологи) к этому относитесь?

[AmuRRR]

Российских работ не встречал.
В виду имелась видимо это:
Ophthalmology. 2011 Jan;118(1):176-83. Epub 2010 Jul 29.
Effects and complications of bevacizumab use in patients with retinopathy of prematurity: a multicenter study in taiwan.

Wu WC, Yeh PT, Chen SN, Yang CM, Lai CC, Kuo HK.

Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Abstract

PURPOSE: To investigate the effects and complications of the anti-vascular endothelial growth factor agent bevacizumab in the treatment of retinopathy of prematurity (ROP) in Taiwanese patients.

DESIGN: A multicenter, retrospective case series study.

PARTICIPANTS: Twenty-seven patients (49 eyes) from 4 medical centers across Taiwan.

METHODS: This study included patients receiving intravitreal injections of bevacizumab (IVB) (0.625 mg) for the treatment of ROP between 2007 and 2009 at 4 major medical centers in Taiwan. The effects and complications associated with this treatment were analyzed. Patients were followed for at least 6 months after bevacizumab injection.

MAIN OUTCOME MEASURES: Regression of ROP and the complications associated with the injection of bevacizumab.

RESULTS: Forty-nine eyes of 27 patients (18 male and 9 female) were included in the study. Mean gestational age and birth weight were 26.0 ± 2.4 weeks and 971.6 ± 589.6 g, respectively. There were 41 eyes (23 patients) with stage 3 ROP, 6 eyes (3 patients) with stage 4A ROP, and 2 eyes (1 patient) with stage 5 ROP. All of the eyes received only a single injection of IVB. The mean injection time was 36.8 ± 2.6 weeks postmenstrual age for eyes with stage 3 ROP. A total of 37 of 41 eyes (90%) with stage 3 ROP regressed after bevacizumab injection only. Four eyes (10%) required additional laser treatment to regress the ROP. Of 6 eyes (3 patients) with stage 4A ROP, 2 eyes (1 patient; 33%) regressed after bevacizumab injection and 4 eyes (67%) regressed after bevacizumab injection and subsequent vitrectomy. The 2 eyes with stage 5 ROP exhibited decreased vascular tortuosity after bevacizumab injection, but the retina failed to reattach after vitrectomy surgeries. Major complications included vitreous or pre-retinal hemorrhage in 4 eyes (8%) and transient vascular sheathing in 2 eyes (4%).

CONCLUSIONS: Bevacizumab injection seems effective and well tolerated in some cases of ROP, especially in stage 3 ROP. Ocular complications could result from the injection of bevacizumab in pediatric eyes.

Основное: 49 ГЛАЗ 27 ПАЦИЕНТОВ, средний гестационный возраст 26 нед., ср вес при рождении около килограмма плюс-минус полкило. 41 глаз со ст. 3 РОП.
В 90 % глаз со ст. 3 был получен регресс с инъекции Авастина, остальные - + лазеркоагуляция.
Вывод: Инъекции бевацизумаба представляются эффективными и хорошо переносимыми в некоторых случаях РОП, особенно в ст. 3. Глазные осложнения могут быть связаны с самой процедурой инъекции.

Ещё источники для вдохновения:.
.................................................. .................................................. ..
1.

Choroidal ruptures after adjuvant intravitreal injection of bevacizumab for aggressive posterior retinopathy of prematurity.

Atchaneeyasakul LO, Trinavarat A.

J Perinatol. 2010 Jul;30(7):497-9.PMID: 20585321 [PubMed - indexed for MEDLINE]Related citations
2.

A new, theoretically safer method of intravitreal injection of bevacizumab in progressive retinopathy of prematurity using scleral trans-illumination.

Patel CK, Walker NJ, Kam JK.

Br J Ophthalmol. 2010 Aug;94(8):1107-9. Epub 2010 Jun 16. Review. No abstract available. PMID: 20558426 [PubMed - indexed for MEDLINE]Related citations
s
4.

Effects of intravitreal bevacizumab and laser in retinopathy of prematurity therapy on the development of peripheral retinal vessels.

Lee JY, Chae JB, Yang SJ, Yoon YH, Kim JG.

Graefes Arch Clin Exp Ophthalmol. 2010 Sep;248(9):1257-62.PMID: 20393741 [PubMed - indexed for MEDLINE]Related citations
5.

Treatment of type 1 retinopathy of prematurity with intravitreal bevacizumab (Avastin).

Dorta P, Kychenthal A.

Retina. 2010 Apr;30(4 Suppl):S24-31.PMID: 20224475 [PubMed - indexed for MEDLINE]Related citations
6.

Antiangiogenic therapy with intravitreal bevacizumab for retinopathy of prematurity.

Quiroz-Mercado H, Martinez-Castellanos MA, Hernandez-Rojas ML, Salazar-Teran N, Chan RV.

Retina. 2008 Mar;28(3 Suppl):S19-25. Erratum in: Retina. 2009 Jan;29(1):127. PMID: 18317339 [PubMed - indexed for MEDLINE]Related citations
7.

Intravitreal bevacizumab in aggressive posterior retinopathy of prematurity.

Travassos A, Teixeira S, Ferreira P, Regadas I, Travassos AS, Esperancinha FE, Prieto I, Pires G, van Velze R, Valido A, Machado Mdo C.

Ophthalmic Surg Lasers Imaging. 2007 May-Jun;38(3):233-7.PMID: 17552391 [PubMed - indexed for MEDLINE]Related citations

[Gratis]

Спасибо за внимание к теме и источники.
Но насколько я понял у нас этим ни кто не занимался? Или нет публикаций?
Если он эффективен и безопасен, тогда почему?

[opto_dive]

потому что не сертифицирован при глазных заболеваниях, тем более у недоношенных детей и нет доказательств, что эффективнее и безопаснее лазеркоагуляции.

[Dr-vasiliY]

Я знаю в Калужском МНТК в/в используют в дополнение к ЛК в тяжелых случаях, но по эффекту сказать не могу.