CRVO并发黄斑水肿患者视力提高和黄斑厚度降低:有高质量的证据表明,与观察组相比,雷珠单抗(0.5mg)显著提高患眼的视力(平均为14.9个字母),视力至少提高3行的百分比为47.7%,至少提高20/40的百分比为46.9%,降低黄斑厚度的百分比为97.3%并改善黄斑水肿。平均治疗次数是每6个月5-6次。雷珠单抗初始6个月用0.5mg,33.1%有视力改善。[31]Campochiaro PA, Brown DM, Awh CC, et al. Sustained benefits from ranibizumab for macular edema following central retinal vein occlusion: twelve-month outcomes of a phase III study. Ophthalmology. 2011;118:2041-2049.http://www.ncbi.nlm.nih.gov/pubmed/21715011?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
CRVO并发黄斑水肿患者视力提高和黄斑厚度降低:有高质量的证据表明,与观察组相比,雷珠单抗(0.5mg)显著提高患眼的视力(平均为14.9个字母),视力至少提高3行的百分比为47.7%,至少提高20/40的百分比为46.9%,降低黄斑厚度的百分比为97.3%并改善黄斑水肿。平均治疗次数是每6个月5-6次。雷珠单抗初始6个月用0.5mg,33.1%有视力改善。[31]Campochiaro PA, Brown DM, Awh CC, et al. Sustained benefits from ranibizumab for macular edema following central retinal vein occlusion: twelve-month outcomes of a phase III study. Ophthalmology. 2011;118:2041-2049.http://www.ncbi.nlm.nih.gov/pubmed/21715011?tool=bestpractice.com
BRVO并发黄斑水肿患者视力提高:有高质量的证据表明,应用雷珠单抗比常规疗法治疗BRVO并发黄斑水肿能显著提高视力和减轻黄斑水肿。[32]Brown DM, Campochiaro PA, Bhisitkul RB, et al. Sustained benefits from ranibizumab for macular edema following branch retinal vein occlusion: 12-month outcomes of a phase III study. Ophthalmology. 2011;118:1594-1602.http://www.ncbi.nlm.nih.gov/pubmed/21684606?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
BRVO并发黄斑水肿患者视力提高:有高质量的证据表明,应用雷珠单抗比常规疗法治疗BRVO并发黄斑水肿能显著提高视力和减轻黄斑水肿。[32]Brown DM, Campochiaro PA, Bhisitkul RB, et al. Sustained benefits from ranibizumab for macular edema following branch retinal vein occlusion: 12-month outcomes of a phase III study. Ophthalmology. 2011;118:1594-1602.http://www.ncbi.nlm.nih.gov/pubmed/21684606?tool=bestpractice.com
避免副作用:有高质量的证据表明,贝伐单抗副作用的发生概率低(系统回顾文献报道7113次注射的副作用的发生概率为0.21%)。[47]Lynch SS, Cheng CM. Bevacizumab for neovascular ocular diseases. Ann Pharmacother. 2007;41:614-625.http://www.ncbi.nlm.nih.gov/pubmed/17355998?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
避免副作用:有高质量的证据表明,贝伐单抗副作用的发生概率低(系统回顾文献报道7113次注射的副作用的发生概率为0.21%)。[47]Lynch SS, Cheng CM. Bevacizumab for neovascular ocular diseases. Ann Pharmacother. 2007;41:614-625.http://www.ncbi.nlm.nih.gov/pubmed/17355998?tool=bestpractice.com
CRVO或BRVO并发黄斑水肿患者视力提高:有高质量的证据表明,在2个月的随访中,相比安慰治疗,玻璃体腔内注射地塞米松能提高视力至<20/20,并能改善持续的黄斑水肿患者的视力。[68]Haller JA, Bandello F, Belfort R Jr, et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results. Ophthalmology. 2011;118:2453-2460.http://www.ncbi.nlm.nih.gov/pubmed/21764136?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
CRVO或BRVO并发黄斑水肿患者视力提高:有高质量的证据表明,在2个月的随访中,相比安慰治疗,玻璃体腔内注射地塞米松能提高视力至<20/20,并能改善持续的黄斑水肿患者的视力。[68]Haller JA, Bandello F, Belfort R Jr, et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results. Ophthalmology. 2011;118:2453-2460.http://www.ncbi.nlm.nih.gov/pubmed/21764136?tool=bestpractice.com
BRVO并发黄斑水肿患者视力提高:有中等质量的证据表明,在3年随访中,与未治疗者比较,格栅样激光光凝术有效提高视力和减少黄斑水肿。激光治疗的适应证为BRVO并发黄斑水肿且视力低于20/40、荧光素眼底血管造影示视盘区非缺血、黄斑中央凹没有出血、疾病持续时间至少3个月。[28]The Branch Vein Occlusion Study Group. Argon laser photocoagulation for macular edema in branch vein occlusion. Am J Ophthalmol. 1984;98:271-282.http://www.ncbi.nlm.nih.gov/pubmed/6383055?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
BRVO并发黄斑水肿患者视力提高:有中等质量的证据表明,在3年随访中,与未治疗者比较,格栅样激光光凝术有效提高视力和减少黄斑水肿。激光治疗的适应证为BRVO并发黄斑水肿且视力低于20/40、荧光素眼底血管造影示视盘区非缺血、黄斑中央凹没有出血、疾病持续时间至少3个月。[28]The Branch Vein Occlusion Study Group. Argon laser photocoagulation for macular edema in branch vein occlusion. Am J Ophthalmol. 1984;98:271-282.http://www.ncbi.nlm.nih.gov/pubmed/6383055?tool=bestpractice.com
CRVO并发黄斑水肿患者视力提高:有中等质量的证据表明,阿柏西普提高CRVO并发黄斑水肿患者的视力(定义为>15个字母)。患者接受为期 6 个月的阿柏西普或虚假治疗,随后根据需要进行为期 6 个月的阿柏西普治疗。在阿柏西普治疗组中,55.3% 的眼睛视力得到了显著提高,而在虚假阿柏西普治疗组中,30.1% 的眼睛视力得到了显著提高。平均视敏度分别提高16.2和3.8个字母。减少黄斑水肿的效果在两组间类似。[53]Brown DM, Heier JS, Clark WL, et al. Intravitreal aflibercept injection for macular edema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS study. Am J Ophthalmol. 2013;155:429-437.http://www.ncbi.nlm.nih.gov/pubmed/23218699?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
CRVO并发黄斑水肿患者视力提高:有中等质量的证据表明,阿柏西普提高CRVO并发黄斑水肿患者的视力(定义为>15个字母)。患者接受为期 6 个月的阿柏西普或虚假治疗,随后根据需要进行为期 6 个月的阿柏西普治疗。在阿柏西普治疗组中,55.3% 的眼睛视力得到了显著提高,而在虚假阿柏西普治疗组中,30.1% 的眼睛视力得到了显著提高。平均视敏度分别提高16.2和3.8个字母。减少黄斑水肿的效果在两组间类似。[53]Brown DM, Heier JS, Clark WL, et al. Intravitreal aflibercept injection for macular edema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS study. Am J Ophthalmol. 2013;155:429-437.http://www.ncbi.nlm.nih.gov/pubmed/23218699?tool=bestpractice.com
CRVO并发黄斑水肿患者症状改善:有低质量的证据表明贝伐单抗改善CRVO并发黄斑水肿患者的症状。[35]Rosenfeld PJ, Fung AE, Puliafito CA. Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for macular edema from central retinal vein occlusion. Ophthalmic Surg Lasers Imaging. 2005;36:336-339.http://www.ncbi.nlm.nih.gov/pubmed/16156153?tool=bestpractice.com[36]Iturralde D, Spaide RF, Meyerle CB, et al. Intravitreal bevacizumab (Avastin) treatment of macular edema in central retinal vein occlusion: a short-term study. Retina. 2006;26:279-284.http://www.ncbi.nlm.nih.gov/pubmed/16508427?tool=bestpractice.com[37]Pai SA, Shetty R, Vijayan PB, et al. Clinical, anatomic, and electrophysiologic evaluation following intravitreal bevacizumab for macular edema in retinal vein occlusion. Am J Ophthalmol. 2007;143:601-606.http://www.ncbi.nlm.nih.gov/pubmed/17306753?tool=bestpractice.com[38]Priglinger SG, Wolf AH, Kreutzer TC, et al. Intravitreal bevacizumab injections for treatment of central retinal vein occlusion: six-month results of a prospective trial. Retina. 2007;27:1004-1012.http://www.ncbi.nlm.nih.gov/pubmed/18040236?tool=bestpractice.com[39]Hsu J, Kaiser RS, Sivalingam A, et al. Intravitreal bevacizumab (Avastin) in central retinal vein occlusion. Retina. 2007;27:1013-1019.http://www.ncbi.nlm.nih.gov/pubmed/18040237?tool=bestpractice.com[40]Kriechbaum K, Michels S, Prager F, et al. Intravitreal Avastin for macular oedema secondary to retinal vein occlusion: a prospective study. Br J Ophthalmol. 2008;92:518-522.http://www.ncbi.nlm.nih.gov/pubmed/18211942?tool=bestpractice.com[41]Pournaras JA, Nguyen C, Vaudaux JD, et al. Treatment of central retinal vein occlusion-related macular edema with intravitreal bevacizumab (Avastin): preliminary results. Klin Monastbl Augenheilkd. 2008;225:397-400.http://www.ncbi.nlm.nih.gov/pubmed/18454380?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
CRVO并发黄斑水肿患者症状改善:有低质量的证据表明贝伐单抗改善CRVO并发黄斑水肿患者的症状。[35]Rosenfeld PJ, Fung AE, Puliafito CA. Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for macular edema from central retinal vein occlusion. Ophthalmic Surg Lasers Imaging. 2005;36:336-339.http://www.ncbi.nlm.nih.gov/pubmed/16156153?tool=bestpractice.com[36]Iturralde D, Spaide RF, Meyerle CB, et al. Intravitreal bevacizumab (Avastin) treatment of macular edema in central retinal vein occlusion: a short-term study. Retina. 2006;26:279-284.http://www.ncbi.nlm.nih.gov/pubmed/16508427?tool=bestpractice.com[37]Pai SA, Shetty R, Vijayan PB, et al. Clinical, anatomic, and electrophysiologic evaluation following intravitreal bevacizumab for macular edema in retinal vein occlusion. Am J Ophthalmol. 2007;143:601-606.http://www.ncbi.nlm.nih.gov/pubmed/17306753?tool=bestpractice.com[38]Priglinger SG, Wolf AH, Kreutzer TC, et al. Intravitreal bevacizumab injections for treatment of central retinal vein occlusion: six-month results of a prospective trial. Retina. 2007;27:1004-1012.http://www.ncbi.nlm.nih.gov/pubmed/18040236?tool=bestpractice.com[39]Hsu J, Kaiser RS, Sivalingam A, et al. Intravitreal bevacizumab (Avastin) in central retinal vein occlusion. Retina. 2007;27:1013-1019.http://www.ncbi.nlm.nih.gov/pubmed/18040237?tool=bestpractice.com[40]Kriechbaum K, Michels S, Prager F, et al. Intravitreal Avastin for macular oedema secondary to retinal vein occlusion: a prospective study. Br J Ophthalmol. 2008;92:518-522.http://www.ncbi.nlm.nih.gov/pubmed/18211942?tool=bestpractice.com[41]Pournaras JA, Nguyen C, Vaudaux JD, et al. Treatment of central retinal vein occlusion-related macular edema with intravitreal bevacizumab (Avastin): preliminary results. Klin Monastbl Augenheilkd. 2008;225:397-400.http://www.ncbi.nlm.nih.gov/pubmed/18454380?tool=bestpractice.com
BRVO并发黄斑水肿患者症状改善:有低质量证据表明贝伐单抗改善BRVO并发黄斑水肿患者的症状。[43]Spandau U, Wickenhauser A, Rensch F, et al. Intravitreal bevacizumab for branch retinal vein occlusion. Acta Ophthalmol Scand. 2007;85:118-119.http://www.ncbi.nlm.nih.gov/pubmed/17244225?tool=bestpractice.com[44]Rabena MD, Pieramici DJ, Castellarin AA, et al. Intravitreal bevacizumab (Avastin) in the treatment of macular edema secondary to branch retinal vein occlusion. Retina. 2007;27:419-425.http://www.ncbi.nlm.nih.gov/pubmed/17420692?tool=bestpractice.com[45]Wu L, Arevalo JF, Roca JA, et al. Comparison of two doses of intravitreal bevacizumab (Avastin) for treatment of macular edema secondary to branch retinal vein occlusion: results from the Pan-American Collaborative Retina Study Group at 6 months of follow-up. Retina. 2008;28:212-219.http://www.ncbi.nlm.nih.gov/pubmed/18301025?tool=bestpractice.com[46]Kreutzer TC, Alge CS, Wolf AH, et al. Intravitreal bevacizumab for the treatment of macular oedema secondary to branch retinal vein occlusion. Br J Ophthalmol. 2008;92:351-355.http://www.ncbi.nlm.nih.gov/pubmed/18211925?tool=bestpractice.com[40]Kriechbaum K, Michels S, Prager F, et al. Intravitreal Avastin for macular oedema secondary to retinal vein occlusion: a prospective study. Br J Ophthalmol. 2008;92:518-522.http://www.ncbi.nlm.nih.gov/pubmed/18211942?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
BRVO并发黄斑水肿患者症状改善:有低质量证据表明贝伐单抗改善BRVO并发黄斑水肿患者的症状。[43]Spandau U, Wickenhauser A, Rensch F, et al. Intravitreal bevacizumab for branch retinal vein occlusion. Acta Ophthalmol Scand. 2007;85:118-119.http://www.ncbi.nlm.nih.gov/pubmed/17244225?tool=bestpractice.com[44]Rabena MD, Pieramici DJ, Castellarin AA, et al. Intravitreal bevacizumab (Avastin) in the treatment of macular edema secondary to branch retinal vein occlusion. Retina. 2007;27:419-425.http://www.ncbi.nlm.nih.gov/pubmed/17420692?tool=bestpractice.com[45]Wu L, Arevalo JF, Roca JA, et al. Comparison of two doses of intravitreal bevacizumab (Avastin) for treatment of macular edema secondary to branch retinal vein occlusion: results from the Pan-American Collaborative Retina Study Group at 6 months of follow-up. Retina. 2008;28:212-219.http://www.ncbi.nlm.nih.gov/pubmed/18301025?tool=bestpractice.com[46]Kreutzer TC, Alge CS, Wolf AH, et al. Intravitreal bevacizumab for the treatment of macular oedema secondary to branch retinal vein occlusion. Br J Ophthalmol. 2008;92:351-355.http://www.ncbi.nlm.nih.gov/pubmed/18211925?tool=bestpractice.com[40]Kriechbaum K, Michels S, Prager F, et al. Intravitreal Avastin for macular oedema secondary to retinal vein occlusion: a prospective study. Br J Ophthalmol. 2008;92:518-522.http://www.ncbi.nlm.nih.gov/pubmed/18211942?tool=bestpractice.com
CRVO并发黄斑水肿患者视力提高和水肿改善:有低质量的证据表明曲安奈德可以提高CRVO并发黄斑水肿患者视力和改善水肿。[55]Greenberg PB, Martidis A, Rogers AH, et al. Intravitreal triamcinolone acetonide injection for macular oedema due to central retinal vein occlusion. Br J Ophthalmol. 2002;86:247-248.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1771005/http://www.ncbi.nlm.nih.gov/pubmed/11815359?tool=bestpractice.com[56]Jonas JB, Kreissig I, Degenring RF. Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. 2002;240:782-783.http://www.ncbi.nlm.nih.gov/pubmed/12271378?tool=bestpractice.com[57]Park CH, Jaffe GJ, Fekrat S. Intravitreal triamcinolone acetonide in eyes with cystoid macular edema associated with central retinal vein occlusion. Am J Ophthalmol. 2003;136:419-425.http://www.ncbi.nlm.nih.gov/pubmed/12967793?tool=bestpractice.com[58]Ip MS, Gottlieb JL, Kahana A, et al. Intravitreal triamcinolone for the treatment of macular edema associated with central retinal vein occlusion. Arch Ophthalmol. 2004;122:1131-1136.http://www.ncbi.nlm.nih.gov/pubmed/15302652?tool=bestpractice.com[59]Bashshur ZF, Ma'luf RN, Allam S, et al. Intravitreal triamcinolone for the management of macular edema due to nonischemic central retinal vein occlusion. Arch Ophthalmol. 2004;122:1137-1140.http://www.ncbi.nlm.nih.gov/pubmed/15302653?tool=bestpractice.com[60]Williamson TH, O'Donnell A. Intravitreal triamcinolone acetonide for cystoid macular edema in nonischemic central retinal vein occlusion. Am J Ophthalmol. 2005;139:860-866.http://www.ncbi.nlm.nih.gov/pubmed/15860292?tool=bestpractice.com[61]Cekic O, Chang S, Tseng JJ, et al. Intravitreal triamcinolone treatment for macular edema associated with central retinal vein occlusion and hemiretinal vein occlusion. Retina. 2005;25:846-850.http://www.ncbi.nlm.nih.gov/pubmed/16205562?tool=bestpractice.com[62]Gregori NZ, Rosenfeld PJ, Puliafito CA, et al. One-year safety and efficacy of intravitreal triamcinolone acetonide for the management of macular edema secondary to central retinal vein occlusion. Retina. 2006;26:889-895.http://www.ncbi.nlm.nih.gov/pubmed/17031288?tool=bestpractice.com[63]Goff MJ, Jumper JM, Yang SS, et al. Intravitreal triamcinolone acetonide treatment of macular edema associated with central retinal vein occlusion. Retina. 2006;26:896-901.http://www.ncbi.nlm.nih.gov/pubmed/17031289?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
CRVO并发黄斑水肿患者视力提高和水肿改善:有低质量的证据表明曲安奈德可以提高CRVO并发黄斑水肿患者视力和改善水肿。[55]Greenberg PB, Martidis A, Rogers AH, et al. Intravitreal triamcinolone acetonide injection for macular oedema due to central retinal vein occlusion. Br J Ophthalmol. 2002;86:247-248.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1771005/http://www.ncbi.nlm.nih.gov/pubmed/11815359?tool=bestpractice.com[56]Jonas JB, Kreissig I, Degenring RF. Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. 2002;240:782-783.http://www.ncbi.nlm.nih.gov/pubmed/12271378?tool=bestpractice.com[57]Park CH, Jaffe GJ, Fekrat S. Intravitreal triamcinolone acetonide in eyes with cystoid macular edema associated with central retinal vein occlusion. Am J Ophthalmol. 2003;136:419-425.http://www.ncbi.nlm.nih.gov/pubmed/12967793?tool=bestpractice.com[58]Ip MS, Gottlieb JL, Kahana A, et al. Intravitreal triamcinolone for the treatment of macular edema associated with central retinal vein occlusion. Arch Ophthalmol. 2004;122:1131-1136.http://www.ncbi.nlm.nih.gov/pubmed/15302652?tool=bestpractice.com[59]Bashshur ZF, Ma'luf RN, Allam S, et al. Intravitreal triamcinolone for the management of macular edema due to nonischemic central retinal vein occlusion. Arch Ophthalmol. 2004;122:1137-1140.http://www.ncbi.nlm.nih.gov/pubmed/15302653?tool=bestpractice.com[60]Williamson TH, O'Donnell A. Intravitreal triamcinolone acetonide for cystoid macular edema in nonischemic central retinal vein occlusion. Am J Ophthalmol. 2005;139:860-866.http://www.ncbi.nlm.nih.gov/pubmed/15860292?tool=bestpractice.com[61]Cekic O, Chang S, Tseng JJ, et al. Intravitreal triamcinolone treatment for macular edema associated with central retinal vein occlusion and hemiretinal vein occlusion. Retina. 2005;25:846-850.http://www.ncbi.nlm.nih.gov/pubmed/16205562?tool=bestpractice.com[62]Gregori NZ, Rosenfeld PJ, Puliafito CA, et al. One-year safety and efficacy of intravitreal triamcinolone acetonide for the management of macular edema secondary to central retinal vein occlusion. Retina. 2006;26:889-895.http://www.ncbi.nlm.nih.gov/pubmed/17031288?tool=bestpractice.com[63]Goff MJ, Jumper JM, Yang SS, et al. Intravitreal triamcinolone acetonide treatment of macular edema associated with central retinal vein occlusion. Retina. 2006;26:896-901.http://www.ncbi.nlm.nih.gov/pubmed/17031289?tool=bestpractice.com