眼内抗血管生成药物临床应用的利与弊被引量：36

Intraocular antiangiogenic drugs in clinical application advantages and disadvantages

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摘要在视网膜血管性疾病的病理改变过程中，血管内皮生长因子（VEGF）呈高表达状态；抗VEGF治疗的临床试验证实，治疗可使脉络膜新生血管膜缩小、液体渗漏减少，在新生血管性年龄相关性黄斑变性、各种病因的脉络膜新生血管膜、糖尿病和静脉阻塞导致的黄斑水肿、早产儿视网膜病变及新生血管性青光眼的治疗中，抗VEGF治疗显示出一定程度的有效性。目前研究者对临床抗VEGF治疗的适应证尚存争议，如增生性糖尿病视网膜病变、糖尿病性视网膜病变玻璃体手术前应用血管生成抑制剂，Coats病的抗VEGF治疗等。争议的焦点是抗VEGF制剂可以加重组织纤维膜的形成。目前临床应用的抗VEGF药物半衰期短，多种疾病（如年龄相关性黄斑变性）需要频繁行眼内注药治疗，潜在发生眼内炎的风险，这是抗VEGF治疗存在的明显问题。（手华聪科杂志，2012。 Many retinal vascular diseases have all been shown to share the upregulation of VEGF expression of vascular endothelial growth factor （VEGF） in the pathologies, recent clinical trials regarding the intravitreal injection of anti-VEGF agents have shown a shrink of CNV and decreased leakage. Certain efficacy was shown in the treatment of angiogenic pathologies including neovascular AMD, choroidal neovascularization caused by several different causes, macular edema by diabetic retinopathy and vein occlusion, Retinopathy of prematurity, and neovascular glaucoma. A controversies in the indication of treatment using anti-VEGF are： inhibit the new vessels of proliferative diabetic retinopathy？ decreased bleeding using intravitreal bevacizumab before vitrectomy of diabetic retinopathy？ reduced leaking in Coats Diseases？ The controversy based on a new finding of fibrosis formation after using intravitreal anti-VEGF. however, recurrent/persistent leaking from CNV or macular edema is common, there is a potential risk of endophthalmitis for frequently intravitreal injections. （Chin J Ophthalmol , 2012,48：870-873 ）

作者黎晓新

机构地区北京大学人民医院眼科、教育部视觉损伤与修复重点实验室

出处《中华眼科杂志》 CAS CSCD 北大核心 2012年第10期870-873,共4页 Chinese Journal of Ophthalmology

关键词视网膜新生血管化新生血管化病理性血管生成抑制剂血管内皮生长因子A Retinal neovascularization Neovascularization pathologic Angiogenesis inhibitors Vascular endothelial growth factor A

分类号 R774 [医药卫生—眼科]

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