Progress of intravitreal anti-vascular endothelial growth factor during pregnancy

Q4 Medicine

中华眼底病杂志 Pub Date : 2020-04-25 DOI:10.3760/CMA.J.CN511434-20180731-00261

J. Lao, J. Mao, Lijun Shen

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引用次数: 1

Abstract

Intravitreal anti-VEGF injection have been widely used in retinal vascular diseases and achieved good efficacy. Early pregnancy is an important period for fetal organ formation and vascular development. Studies have proved that VEGF plays an important role in maintaining the fetal and placental vascular system, and its loss or decline will affect embryonic development and lead to abortion. The use of intravitreal anti-VEGF during pregnancy is controversial, which may cause systemic side effects to the mother and fetus. This paper summarizes the literature of 23 cases on the use of anti-VEGF during pregnancy. Three cases reported loss of pregnancy with concomitant exposure to intravitreal bevacizumab, which suggested that we should be careful about the use of anti-VEGF during pregnancy and explain the possibility of ocular and systemic side effects to patients in detail. When deciding whether to use anti-VEGF, we should consider the relationship between exposure time and the critical period of vascular development and the systemic exposure of different drugs. Currently, there is a lack of large sample size studies on the use of anti-VEGF in pregnancy, and its safety needs to be further observed. Key words: Pregnant women; Angiogenesis inhibitors/adverse effects; Review

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妊娠期玻璃体内抗血管内皮生长因子研究进展

玻璃体内抗vegf注射已广泛应用于视网膜血管疾病，并取得了良好的疗效。妊娠早期是胎儿器官形成和血管发育的重要时期。研究证明，VEGF在维持胎儿和胎盘血管系统中起着重要作用，其缺失或下降会影响胚胎发育，导致流产。妊娠期间玻璃体内抗vegf的使用是有争议的，这可能会对母亲和胎儿产生全身副作用。本文总结了23例妊娠期抗vegf应用的文献。有3例患者因同时使用玻璃体内贝伐单抗导致妊娠失败，提示我们在妊娠期间应谨慎使用抗vegf药物，并向患者详细解释可能出现的眼部和全身副作用。在决定是否使用抗vegf时，应考虑暴露时间与血管发育关键期的关系以及不同药物的全身暴露情况。目前，抗vegf在妊娠期的应用缺乏大样本量的研究，其安全性有待进一步观察。关键词:孕妇;血管生成抑制剂/不良反应;审查

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来源期刊

中华眼底病杂志 Medicine-Ophthalmology

CiteScore

0.40

自引率

0.00%

发文量

5383

期刊介绍： Chinese Journal of Ocular Fundus Diseases is the only scientific journal in my country that focuses on reporting fundus diseases. Its purpose is to combine clinical and basic research, and to give equal importance to improvement and popularization. It comprehensively reflects the leading clinical and basic research results of fundus disease disciplines in my country; cultivates professional talents in fundus disease, promotes the development of fundus disease disciplines in my country; and promotes academic exchanges on fundus disease at home and abroad. The coverage includes clinical and basic research results of posterior segment diseases such as retina, uveal tract, vitreous body, visual pathway, and internal eye diseases related to systemic diseases. The readers are medical workers and researchers related to clinical and basic research of fundus diseases. According to the journal retrieval report of the Chinese Institute of Scientific and Technological Information, the comprehensive ranking impact factor and total citation frequency of the Chinese Journal of Ocular Fundus Diseases have been among the best in the disciplines of ophthalmology, otolaryngology, and ophthalmology in my country for many years. The papers published have been included in many important databases at home and abroad, such as Scopus, Peking University Core, and China Science Citation Database (CSCD).