玻璃体腔注药治疗视网膜静脉阻塞继发黄斑水肿研究进展
Research Progress on Intravitreal Injection Therapy for Macular Edema Secondary to Retinal Vein Occlusion
DOI: 10.12677/acm.2024.14113010, PDF,   
作者: 邓 垚:吉首大学医学院,湖南 吉首;吉首大学第四临床学院,湖南 怀化;于 兰*:吉首大学第四临床学院,湖南 怀化
关键词: 视网膜静脉阻塞黄斑水肿糖皮质激素抗VEGF药Retinal Vein Occlusion Macular Edema Glucocorticoids Anti-VEGF Agents
摘要: 视网膜静脉阻塞(RVO)是临床常见的视网膜血管病,而RVO发生后常继发黄斑水肿(ME)。玻璃体腔注射是治疗RVO-ME的有效且安全的一种给药方式。目前随着医学的进展,用于玻璃体腔注射治疗该种疾病的药物越来越多,主要为糖皮质激素类药物和抗VEGF药物,糖皮质激素包括有曲安奈德、地塞米松、醋酸氟轻松,抗VEGF药物主要有雷珠单抗、贝伐单抗、阿柏西普、康柏西普等。本文将对这些药物在RVO-ME中的治疗进展作综述,以供医疗实践中作参考。
Abstract: Retinal vein occlusion (RVO) is a prevalent retinal vascular disease, which often leads to secondary macular edema (ME). Intravitreal injection has proven to be an effective and safe method of drug delivery for the treatment of RVO-associated ME. With the advancement of medical science, an increasing number of medications are being utilized for intravitreal injections to address this condition, primarily glucocorticoids and anti-VEGF (vascular endothelial growth factor) agents. Glucocorticoids include triamcinolone acetonide, dexamethasone, and fluocinolone acetonide, while anti-VEGF drugs comprise ranibizumab, bevacizumab, aflibercept, and conbercept, among others. This article will provide a comprehensive review of the therapeutic progress of these medications in RVO-ME for reference in medical practice.
文章引用:邓垚, 于兰. 玻璃体腔注药治疗视网膜静脉阻塞继发黄斑水肿研究进展[J]. 临床医学进展, 2024, 14(11): 1263-1271. https://doi.org/10.12677/acm.2024.14113010

参考文献

[1] 李洋, 解颖, 董志军. 视网膜静脉阻塞继发黄斑水肿中OCT生物标志物的研究进展[J]. 国际眼科杂志, 2024, 24(6): 912-916.
[2] Laouri, M., Chen, E., Looman, M. and Gallagher, M. (2011) The Burden of Disease of Retinal Vein Occlusion: Review of the Literature. Eye, 25, 981-988. [Google Scholar] [CrossRef] [PubMed]
[3] Yiu, G., Welch, R.J., Wang, Y., Wang, Z., Wang, P. and Haskova, Z. (2020) Spectral-Domain OCT Predictors of Visual Outcomes after Ranibizumab Treatment for Macular Edema Resulting from Retinal Vein Occlusion. Ophthalmology Retina, 4, 67-76. [Google Scholar] [CrossRef] [PubMed]
[4] Călugăru, D., Călugăru, M. and Ţălu, Ş. (2018) Ocular Hypertension in Patients with Central/Hemicentral Retinal Vein Occlusions: Cumulative Prevalence and Management. International Journal of Ophthalmology, 11, 1173-1178.
http://www.ijo.cn/gjyken/ch/reader/view_abstract.aspx?file_no=20180716&flag=1
[5] 肖婷婷, 汪彬, 屈晓勇, 等. 视网膜静脉阻塞与血液中血小板相关参数及高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平之间的关系[J]. 眼科新进展, 2020, 40(7): 674-676.
[6] Cunha-Vaz, J. (2017) The Blood-Retinal Barrier in the Management of Retinal Disease: EURETINA Award Lecture. Ophthalmologica, 237, 1-10. [Google Scholar] [CrossRef] [PubMed]
[7] Watanabe, K., Masafumi, U., Mohamed, Y.H., Watanabe, T., Doi, Y., Azusa, F., et al. (2017) Safety of Intravitreal Injection Guide. Journal of VitreoRetinal Diseases, 2, 26-31. [Google Scholar] [CrossRef
[8] 郝晓璐, 侯豹可, 郭晓会, 等. 曲安奈德玻璃体腔注射治疗黄斑水肿的疗效及并发症分析[J]. 解放军医学院学报, 2023, 44(11): 1230-1234, 1240.
[9] McAllister, I.L., Vijayasekaran, S., Chen, S.D. and Yu, D. (2009) Effect of Triamcinolone Acetonide on Vascular Endothelial Growth Factor and Occludin Levels in Branch Retinal Vein Occlusion. American Journal of Ophthalmology, 147, 838-846.e2. [Google Scholar] [CrossRef] [PubMed]
[10] 喻晓兵, 师自安, 戴虹, 等. 曲安奈德玻璃体注射治疗视网膜分支静脉阻塞继发黄斑水肿[J]. 中国实用眼科杂志, 2006(10): 1043-1045.
[11] Beer, P.M., Bakri, S.J., Singh, R.J., Liu, W., Peters, G.B. and Miller, M. (2003) Intraocular Concentration and Pharmacokinetics of Triamcinolone Acetonide after a Single Intravitreal Injection. Ophthalmology, 110, 681-686. [Google Scholar] [CrossRef] [PubMed]
[12] 曹婷婷, 刘逾, 高瑞新, 等. 不同剂量的曲安奈德玻璃体腔注射联合光凝治疗视网膜分支静脉阻塞合并黄斑水肿的疗效观察[J]. 实用老年医学, 2016, 30(4): 299-301.
[13] Vander, J.F. (2010) A Randomized Trial Comparing the Efficacy and Safety of Intravitreal Triamcinolone with Standard Care to Treat Vision Loss Associated with Macular Edema Secondary to Branch Retinal Vein Occlusion: The Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) Study Report 6. Yearbook of Ophthalmology, 2010, 141-142. [Google Scholar] [CrossRef
[14] Jonas, J.B. (2003) Intraocular Pressure after Intravitreal Injection of Triamcinolone Acetonide. British Journal of Ophthalmology, 87, 24-27. [Google Scholar] [CrossRef] [PubMed]
[15] Lo Giudice, G., Avarello, A., Campana, G. and Galan, A. (2017) Rapid Response to Dexamethasone Intravitreal Implant in Diabetic Macular Edema. European Journal of Ophthalmology, 28, 74-79. [Google Scholar] [CrossRef] [PubMed]
[16] 刘玉平, 孙晶晶, 孙建标, 等. Ozurdex对视网膜静脉阻塞合并黄斑水肿患者房水内VEGF、IL-6及MCP-1水平的影响[J]. 临床和实验医学杂志, 2023, 22(4): 414-417.
[17] Singer, M.A., Dugel, P.U., Fine, H.F., Capone, A. and Maltman, J. (2018) Real-World Assessment of Dexamethasone Intravitreal Implant in DME: Findings of the Prospective, Multicenter REINFORCE Study. Ophthalmic Surgery, Lasers and Imaging Retina, 49, 425-435. [Google Scholar] [CrossRef] [PubMed]
[18] Dugel, P.U., Bandello, F. and Loewenstein, A. (2015) Dexamethasone Intravitreal Implant in the Treatment of Diabetic Macular Edema. Clinical Ophthalmology, 9, 1321-1335. [Google Scholar] [CrossRef] [PubMed]
[19] Yoshimura, T., Sonoda, K., Sugahara, M., Mochizuki, Y., Enaida, H., Oshima, Y., et al. (2009) Comprehensive Analysis of Inflammatory Immune Mediators in Vitreoretinal Diseases. PLOS ONE, 4, e8158. [Google Scholar] [CrossRef] [PubMed]
[20] Fusi-Rubiano, W., Blow, R.R., Lane, M., Morjaria, R. and Denniston, A.K. (2018) Iluvien™ (Fluocinolone Acetonide 0.19 mg Intravitreal Implant) in the Treatment of Diabetic Macular Edema: A Review. Ophthalmology and Therapy, 7, 293-305. [Google Scholar] [CrossRef] [PubMed]
[21] Ramchandran, R.S., Fekrat, S., Stinnett, S.S. and Jaffe, G.J. (2008) Fluocinolone Acetonide Sustained Drug Delivery Device for Chronic Central Retinal Vein Occlusion: 12-Month Results. American Journal of Ophthalmology, 146, 285-291.e1. [Google Scholar] [CrossRef] [PubMed]
[22] Fallico, M., Maugeri, A., Lotery, A., Longo, A., Bonfiglio, V., Russo, A., et al. (2021) Fluocinolone Acetonide Vitreous Insert for Chronic Diabetic Macular Oedema: A Systematic Review with Meta-Analysis of Real-World Experience. Scientific Reports, 11, Article No. 4800. [Google Scholar] [CrossRef] [PubMed]
[23] 袁思佳, 张相冉, 王延武. 雷珠单抗对新生血管性青光眼患者眼动脉血流动力学、房水血管活性物质和炎性因子表达水平的影响[J]. 四川生理科学杂志, 2024, 46(2): 299-301, 390.
[24] 肖昂. 雷珠单抗经VEGF/STAT3/GFAP信号通路调控早期DR视网膜组织损伤修复的作用及其机制研究[D]: [博士学位论文]. 南昌: 南昌大学医学部, 2022.
[25] 宋华, 李景波. 雷珠单抗治疗视网膜静脉阻塞合并黄斑水肿的疗效及影响视力恢复的因素分析[J]. 国际眼科杂志, 2022, 22(3): 509-512.
[26] Murata, T., Kondo, M., Inoue, M., Nakao, S., Osaka, R., Shiragami, C., et al. (2021) The Randomized ZIPANGU Trial of Ranibizumab and Adjunct Laser for Macular Edema Following Branch Retinal Vein Occlusion in Treatment-Naïve Patients. Scientific Reports, 11, Article No. 551. [Google Scholar] [CrossRef] [PubMed]
[27] Campochiaro, P.A., Heier, J.S., Feiner, L., Gray, S., Saroj, N., Rundle, A.C., et al. (2010) Ranibizumab for Macular Edema Following Branch Retinal Vein Occlusion. Ophthalmology, 117, 1102-1112.e1. [Google Scholar] [CrossRef] [PubMed]
[28] Miwa, Y., Muraoka, Y., Osaka, R., Ooto, S., Murakami, T., Suzuma, K., et al. (2017) Ranibizumab for Macular Edema after Branch Retinal Vein Occlusion: One Initial Injection versus Three Monthly Injections. Retina, 37, 702-709. [Google Scholar] [CrossRef] [PubMed]
[29] 邓月, 牛童童, 李霞, 等. 雷珠单抗用于糖尿病性白内障术后患者药品不良事件的系统性分析[J]. 中国药物应用与监测, 2024, 21(4): 494-498.
[30] Garcia, J., Hurwitz, H.I., Sandler, A.B., Miles, D., Coleman, R.L., Deurloo, R., et al. (2020) Bevacizumab (Avastin®) in Cancer Treatment: A Review of 15 Years of Clinical Experience and Future Outlook. Cancer Treatment Reviews, 86, Article ID: 102017. [Google Scholar] [CrossRef] [PubMed]
[31] Hikichi, T., Higuchi, M., Matsushita, T., Kosaka, S., Matsushita, R., Takami, K., et al. (2013) Two-Year Outcomes of Intravitreal Bevacizumab Therapy for Macular Oedema Secondary to Branch Retinal Vein Occlusion. British Journal of Ophthalmology, 98, 195-199. [Google Scholar] [CrossRef] [PubMed]
[32] 王梅子, 封康, 陆遥, 等. 贝伐单抗治疗视网膜中央静脉阻塞(CRVO)继发黄斑水肿的短期疗效及影响因素分析[J]. 眼科新进展, 2018, 38(12): 1176-1179.
[33] Ito, Y., Saishin, Y., Sawada, O., Kakinoki, M., Miyake, T., Sawada, T., et al. (2015) Comparison of Single Injection and Three Monthly Injections of Intravitreal Bevacizumab for Macular Edema Associated with Branch Retinal Vein Occlusion. Clinical Ophthalmology, 9, 175-180. [Google Scholar] [CrossRef] [PubMed]
[34] Wu, L., Martínez-Castellanos, M.A., Quiroz-Mercado, H., Arevalo, J.F., Berrocal, M.H., Farah, M.E., et al. (2007) Twelve-Month Safety of Intravitreal Injections of Bevacizumab (Avastin®): Results of the Pan-American Collaborative Retina Study Group (Pacores). Graefes Archive for Clinical and Experimental Ophthalmology, 246, 81-87. [Google Scholar] [CrossRef] [PubMed]
[35] Papadopoulos, N., Martin, J., Ruan, Q., Rafique, A., Rosconi, M.P., Shi, E., et al. (2012) Binding and Neutralization of Vascular Endothelial Growth Factor (VEGF) and Related Ligands by VEGF Trap, Ranibizumab and Bevacizumab. Angiogenesis, 15, 171-185. [Google Scholar] [CrossRef] [PubMed]
[36] Korobelnik, J., Holz, F.G., Roider, J., Ogura, Y., Simader, C., Schmidt-Erfurth, U., et al. (2014) Intravitreal Aflibercept Injection for Macular Edema Resulting from Central Retinal Vein Occlusion. Ophthalmology, 121, 202-208. [Google Scholar] [CrossRef] [PubMed]
[37] Sangroongruangsri, S., Ratanapakorn, T., Wu, O., Anothaisintawee, T. and Chaikledkaew, U. (2018) Comparative Efficacy of Bevacizumab, Ranibizumab, and Aflibercept for Treatment of Macular Edema Secondary to Retinal Vein Occlusion: A Systematic Review and Network Meta-Analysis. Expert Review of Clinical Pharmacology, 11, 903-916. [Google Scholar] [CrossRef] [PubMed]
[38] Cai, S. and Bressler, N.M. (2017) Aflibercept, Bevacizumab or Ranibizumab for Diabetic Macular Oedema: Recent Clinically Relevant Findings from DRCR.net Protocol T. Current Opinion in Ophthalmology, 28, 636-643. [Google Scholar] [CrossRef] [PubMed]
[39] Casselholm de Salles, M., Amrén, U., Kvanta, A. and Epstein, D.L. (2019) Injection Frequency of Aflibercept versus Ranibizumab in a Treat-and-Extend Regimen for Central Retinal Vein Occlusion: A Randomized Clinical Trial. Retina, 39, 1370-1376. [Google Scholar] [CrossRef] [PubMed]
[40] Avery, R.L., Castellarin, A.A., Steinle, N.C., Dhoot, D.S., Pieramici, D.J., See, R., et al. (2014) Systemic Pharmacokinetics Following Intravitreal Injections of Ranibizumab, Bevacizumab or Aflibercept in Patients with Neovascular AMD. British Journal of Ophthalmology, 98, 1636-1641. [Google Scholar] [CrossRef] [PubMed]
[41] Korobelnik, J., Larsen, M., Eter, N., Bailey, C., Wolf, S., Schmelter, T., et al. (2021) Efficacy and Safety of Intravitreal Aflibercept Treat-and-Extend for Macular Edema in Central Retinal Vein Occlusion: The CENTERA Study. American Journal of Ophthalmology, 227, 106-115. [Google Scholar] [CrossRef] [PubMed]
[42] Kaiser, S.M., Arepalli, S. and Ehlers, J.P. (2021) Current and Future Anti-VEGF Agents for Neovascular Age-Related Macular Degeneration. Journal of Experimental Pharmacology, 13, 905-912. [Google Scholar] [CrossRef] [PubMed]
[43] 林鹏耀, 施彦, 李波, 等. 玻璃体腔注射康柏西普治疗不同类型视网膜静脉阻塞伴黄斑水肿的疗效[J]. 国际眼科杂志, 2021, 21(12): 2145-2149.
[44] Song, W., Jiao, W., Li, F., Ma, A. and Zhao, B. (2020) Evaluation of Microvascular Structure Changes after Conbercept Treatment on Macular Edema Secondary to Retinal Vein Occlusion. BioMed Research International, 2020, Article ID: 9046781. [Google Scholar] [CrossRef] [PubMed]
[45] Liu, W., Li, Y., Cao, R., Bai, Z. and Liu, W. (2020) A Systematic Review and Meta-Analysis to Compare the Efficacy of Conbercept with Ranibizumab in Patients with Macular Edema Secondary to Retinal Vein Occlusion. Medicine, 99, e20222. [Google Scholar] [CrossRef] [PubMed]
[46] 刘杨, 欧阳先明, 李莉, 等. 康柏西普玻璃体腔注射不同次数治疗糖尿病性黄斑水肿的疗效比较[J]. 临床合理用药, 2024, 17(12): 71-73.
[47] 严然, 高新晓, 朱思泉. 康柏西普治疗视网膜静脉阻塞继发黄斑水肿的疗效[J]. 临床药物治疗杂志, 2020, 18(12): 43-47.
[48] 刘腾, 段直光. 地塞米松植入剂联合康柏西普治疗视网膜静脉分枝阻塞继发黄斑水肿的临床研究[J]. 大理大学学报, 2024, 9(4): 46-51.
[49] 马惠玲, 马丽, 魏丽娜. 玻璃体腔注射康柏西普治疗黄斑水肿的临床疗效[J]. 现代养生, 2024, 24(17): 1285-1288.