眼中風 視網膜分枝靜脈阻塞
以前視網膜雷射是主流，目前則以眼內注射抗血管內皮生長因子為第一線。
Lucentis 及 Eyelea不相上下，Avastin也不錯。
注射類固醇仍有相當的角色。
新藥像是血小板衍生生長因子或是angiopoietin仍在研發中。
" I only do PRP in the rare cases of NV or NVG. ...If I treated the patient pharmacologically either with an anti-VEGF or steroid and there is no response, then I sometimes consider grid laser," ...Dr. Lowenstein.
Lucentis and Eyelea are both approved in the EU and the USA for the treatment of macular oedema following branch and central RVO.
Avastin has shown similar effects in clinical studies and is used off-label.
LEAVO, SCORE2 stduy: non-inferiority study comparing Lucentis and Eyelea in patients with macular oedema associated with central RVO.
Steroid, alone and in conjunctions with anti-VEGF agents also continue to have a role in RVO treatment.
"I usually start with anti-VEGF treatment, Lucentis or Eyelea. If there is a situation where the patient where the patient cannot tolerate the treatment burden and there is constant recurrence, or if there is a situation where the patient has reached a plateau and there is still oedema, I consider using Ozurdex." notes Dr. Dugel.
Platelet-derived growth factor (PDGF) could play a supportive role in combination treatment.
Angiopoietin pathway, REGN910-3, RG7716.
Notes from ESCRS Euro Times Vol 22 Issue 3
展欣眼科 林于皓 醫師
