Луцентис - скажем "нет" ВМД :ay:

[ainakoz]

Ну, во первых:

Position Paper: The Need for Head-to-Head Studies Comparing Avastin versus Lucentis.
Schmucker C, Antes G, Lelgemann M.

German Cochrane Center, University Medical Center Freiburg, Germany.

Требуются исследования сравнивающие авастин с луцентисом. По нашим впечатлениям, ничем пока не подтверждённым, разницы в эффекте нет. Разница в цене. Может у кого другое мнение?

Bevacizumab vs Ranibizumab for Age-related Macular Degeneration: Early Results of a Prospective Double-Masked, Randomized Clinical Trial.
Subramanian ML, Ness S, Abedi G, Ahmed E, Daly M, Feinberg E, Bhatia S, Patel P, Nguyen M, Houranieh A.

Veterans Affairs Boston Healthcare System, Jamaica Plain, Massachusetts; Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts.

CONCLUSION: Early results of a head-to-head, randomized, double-masked, prospective, single-center controlled trial between bevacizumab and ranibizumab show no difference in efficacy between the two treatments for choroidal neovascularizaton in the treatment of age-related macular degeneration. As this study conveys results of a small number of patients, further studies with larger sample sizes are needed in order to establish statistical significance.

Во-вторых:

Anti-VEGF drugs as the 2009 first-line therapy for choroidal neovascularization in pathologic myopia.
Cohen SY.

Centre Ophtalmologique d'Imagerie et de Laser, Paris, France. [Ссылки доступны только зарегистрированным пользователям ]

BACKGROUND: Pathologic myopia is the second cause of choroidal neovascularization, after age-related macular degeneration (AMD), and the first cause in patients younger than 50 years. The current treatment of subfoveal myopic choroidal neovascularization (mCNV) is verteporfin photodynamic therapy, but its long-term effectiveness has been disappointing. Antivascular endothelial growth factor (anti-VEGF) drugs are now widely used not only to treat choroidal neovascularization in AMD but also for choroidal neovascularization in other conditions. This review summarizes the data supplied by published case series studies about anti-VEGF therapy in mCNV. METHODS: Analysis of the current literature allowed discussion of the optimal parameters for mCNV treatment by anti-VEGF, including the choice of anti-VEGF drug, its dose, the treatment protocol, and indications for retreatment. RESULTS: To date, the results of intravitreal bevacizumab or ranibizumab for mCNV have been reported in at least 14 studies, but they were all pilot, monocentric, and noncomparative case series. Nevertheless, they provided useful information on >250 patients and showed similar results, with significant improvement of visual acuity and an excellent safety profile. CONCLUSION: Shifting from one treatment to another is always difficult in the absence of prospective and controlled comparative studies. However, in 2009, intravitreal ranibizumab or bevacizumab may be considered as first-line therapy for sub- and juxtafoveal mCNV for three reasons: the safety of anti-VEGF drugs and intravitreal injection procedures; the disappointing long-term results of other therapies, including verteporfin treatment; and the excellent convergent results of anti-VEGF therapy in all pilot studies.

Речь идёт о шикарных результатах во всех пилотных исследованиях по применению ингибиторов ангиогенеза в лечении миопической ХНВ.

Моё же мнение на сегодняшний день: если есть субфовеолярная ХНВ, то прогноз для центрального зрения не очень благоприятный. В месте бывшей ХНВ после анти-VEGF (равно как и ФДТ) субретинальный фиброз, мешающий так необходимому хореоидальному питанию фоторецепторов фовеолы. Экстрафовеолярные же мембраны можно погреть лазером. И ещё. Заметил, что после введения анти-VEGF часто скрытая ХНВ становится видимой!
Перспективным направлением в этом плане может быть хирургическое удаление субретинальных мембран. (витреоретинальная хирургия) Анти-Ви-И-Джи-Эф пригодятся в лечении пролиферативной ДРП, посттромботической ретинопатиии, и других подобных состояний.