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1 mg
2 mg mg 4 6
3 mg ml 10 mg/ml mg ml 40 mg/ml 1 1mL 4mg 40 mg/ml 0.1 ml 2
4 mg mg 1 4 ml 10 mg/ml mg ml 40 mg/ml 1 1mL 40 mg/ml 4mg 0.1 ml Diabetic Macular Edema; - 3
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10 / mg 12 8 mg 4 mg.. 59: , 2005 Chieh JJ et al. Retina. 25: , 2005 Avitabile T et al. Am J Ophthalmol. 140: , mg mg 33 4 mg FAS ETDRS Early Treatment Diabetic Retinopathy Study 4 m 4 8 mg 4 mg 8 mg 4 mg 4 FAS 8 mg 4 mg ± ± ± ± ± ±11.0 [95% ] a) 4.0 [0.6, 7.5] 4.7 [1.3, 8.1] - p a), b) ± a /8 mg /4 mg LOCF b 8mg 12 8mg 90.9% 30/33 4mg 79.4% 27/ % 14/ mg 12.1% 4/ mg 2.9% 1/ mg mg 1 0% 0/ mg 66.7% 22/33 4mg 41.2% 14/ AAO OCT m 9
11 % mg (33 ) 4mg (34 ) (33 ) 13 (39.4) 11 (32.4) 4 (12.1) 3(9.1) 4(11.8) 0 2(6.1) 0 0 2(6.1) 0 0 1(3.0) 0 3(9.1) 6(18.2) 4(11.8) 1(3.0) 6 (18.2) 2 (5.9) 2 (6.1) 6 (18.2) 3 (8.8) 0 6 (18.2) 8 (23.5) 0 1 (3.0) 3 (8.8) 1 (3.0) 0 2 (5.9) (5.9) 1 (3.0) 3 (9.1) 1 (2.9) mg 9.1% 3/33 4 mg 23.5% 8/34 8 mg 3 4 mg mg 8 mg 0.1 ml 6 8mg mg 9 ETDRS 15 10
12 8 mg 4 mg 95% , , 8.1 ETDRS mg 4 mg 5 p= Fisher s exact test 4 mg 10 p=0.017 Fisher s exact test ETDRS 4 mg VEGF mg 4mg ± 57.8±7.4 (33) 56.0±8.8 (34) 56.6±10.4 (33) FAS ± ± ± ± ± ±13.1 (33) (33) (32) (30) (9) (3) 59.1± ± ± ± ± ±10.7 (34) (34) (34) (34) (18) (6) 58.3± ± ± ±11.2 (33) (33) (32) (32) - - % FAS mg 0 (0/33) 18.2 (6/33) 51.5 (17/33) 42.4 (14/33) 6.1 (2/33) 4 mg 8.8 (3/34) 35.3 (12/34) 52.9 (18/34) 44.1 (15/34) 2.9 (1/34) 6.1 (2/33) 9.1 (3/33) 21.2 (7/33) 57.6 (19/33) 21.2 (7/33).. 111: , / 10 Hauser D et al. Retina. 28: , 2008 Audren F et al. Am J Ophthalmol. 142: , 2006 Kim JE et al. Retina. 28: , 2008 Massin P et al. Ophthalmalogy. 111: , 2004 Larsson J et al. Am J Ophthalmol. 139: , 2005 Audren F et al. Acta Ophthalmol Scand. 84: , 2006 Chung EJ et al. Yonsei Med J. 49: , 2008 Larsson J et al. Acta Ophthalmol. 87: , Cunningham ET Jr et al. Ophthalmology. 112: , 2005 Sultan MB et al. Ophthalmology. 118: , 2011 Massin P et al. Diabetes Care. 33: Beck RW et al. Arch Ophthalmol. 127: , 2009 Elman MJ et al. Ophthalmology. 117: , 2010 Nguyen QD et.al. Ophthalmology. 116: , 2009 Mitchell P et al. Ophthalmology. 118: Cunningham ET Jr et al. Ophthalmology. 112: , 2005 Sultan MB et al. Ophthalmology. 118: , 2011 Nguyen QD et.al. Ophthalmology. 116: , 2009 Massin P et al. Diabetes Care. 33: Mitchell P et al. Ophthalmology. 118: Elman MJ et al. Ophthalmology. 117: ,
13 2 / mg 4 mg 5% 8 % 8 8 mg 4 mg 5% mg (44 ) 4 mg (45 ) 1 mg (11 ) (33 ) 15 (34.1) 12 (26.7) 0 4 (12.1) 3 (6.8) 4 (8.9) (22.7) 9 (20.0) (18.2) 9 (20.0) 4 (36.4) 3 (9.1) 10 (22.7) 5 (11.1) 2 (18.2) 1 (3.0) 6 (13.6) 2 (4.4) 0 2 (6.1) 8 (18.2) 4 (8.9) 2 (18.2) 0 15 (34.1) 10 (22.2) 1 (9.1) 0 2 (4.5) 4 (8.9) 0 1 (3.0) 1 (2.3) 4 (8.9) 1 (9.1) 0 3 (6.8) 1 (2.2) / mg 15/44 4 mg 10/45 1 mg 1/11 30 mmhg 8mg 5 4mg 4 1mg 1 8mg 44 mmhg 4mg 38 mmhg 1 mg 30 mmhg mg mg mg 1 8 mg 4 mg 2 8 mg 9 4 mg 4 1 mg mg 4 4 mg 3 8 mg 2 4 mg / mmhg 24 mmhg 1 50 mmhg / mmhg 12
14 9 mmhg mg 4 mg 14.8±3.8 [8, 21] (33) 15.2±2.7 [10, 21] (34) 15.1±3.0 [11, 20] (33) ±5.9 [8, 44] (33) 15.8±3.8 [10, 25] (34) 14.7±3.1 [10, 20] (33) ±3.8 [8, 28] (33) 16.6±3.5 [10, 26] (34) 14.5±2.9 [10, 20] (33) ±3.5 [11, 27] (32) 18.1±4.4 [10, 35] (34) 14.1±3.0 [11, 22] (24) ±4.1 [11, 26] (31) 17.7±3.6 [11, 26] (34) 14.5±2.7 [11, 21] (21) ±8.2 [10, 39] (13) 17.9±5.9 [11, 38] (21) ±4.9 [8, 21] (7) 14.7±3.5 [11, 21] (7) ±3.6 [14, 21] (3) 10 (1) - ± [, ] mg 4 mg 1 mg 1001 (11 ) 4002 (33 ) (44 ) 1001 (11 ) 4002 (34 ) (45 ) 1001 (11 ) 4002 (33 ) * 5 (45.5) 10 (30.3) 15 (34.1) 0 10 (29.4)** 10 (22.2) 1 (9.1) 0 3 (27.3) 6 (18.2) 9 (20.5) 0 8 (23.5) 8 (17.8) 1 (9.1) (18.2) 4 (12.1) 6 (13.6) 0 3 (8.8) 3 (6.7) 0 - % * ** , : 18 / 1001 / % 19/133 8 mg 10/44 4 mg 9/ mg 8 4 mg mg 1 4 mg
15 6 8 mg 3 4 mg mg 7 4 mg mg 3 4 mg 1 8mg mg mg mg 8 5 4mg mg 1 4 mg mg 4 mg 1 mg 1001 (11 ) 4002 (33 ) (44 ) 1001 (11 ) 4002 (34 ) (45 ) 1001 (11 ) 4002 (33 ) * 5 (45.5) 5 (15.2) 10 (22.7) 1 (9.1) 8 (23.5) 9 (20.0) (6.1) 2 (4.5) (45.5) 3 (9.1) 8 (18.2) 1 (9.1) 8 (23.5) 9 (20.0) 0 - % * mg mg % 14
16 % mg % 21 / mg 4 mg 20.0% 9/ , mg Diabetic Retinopathy Clinical Research Network. Ophthalmology. 115: , 2008 Beck RW et al. Arch Ophthalmol. 127: , 2009 Hauser D et al. Retina. 28: , 2008 Audren F et al. Am J Ophthalmol. 142: , 2006 Kim JE et al. Retina. 28: , 2008 Massin P et al. Ophthalmology. 111: , 2004 Audren F et al. Acta Ophthalmol Scand. 84: , 2006 Chung EJ et al. Yonsei Med J. 49: , 2008 Larsson J et al. Acta Ophthalmol. 87: , 2009 Martidis A et al. Ophthalmology. 109: , 2002 Sutter FK et al. Ophthalmol. 111: , 2004 Negi AK et al. Eye. 19: , 2005 Avci R et al. Clin Experiment Ophthalmol. 34: 27-32, 2006 Kang SW et al. Arch Ophthalmol. 124: , 2006 Gibran SK et al. Eye. 20: , 2006 Ozdemir H et al. Am J Ophthalmol. 140: , 2005 Lee WF and Yang CM. J Formos Med Assoc. 103: , 2004 Ramezani A et al. Korean J Ophthalmol. 21: 95-99, 2007 Lam DS et al. Ophthalmology. 114: , 2007 Dehghan MH et al. Int Ophthalmol. 28: 7-17, 2008 Bae JS et al. Korean J Ophthalmol. 23: 80-85, 2009 Yalcinbayir O et al. Ophthalmologica. 225: , 2011 Gillies MC et al. Ophthalmology. 118: , 2011 Gillies MC et al. Clin Experiment Ophthalmol. 38: , 2010 Elman MJ et al. Ophthalmology. 117: , 2010 Mirshahi A et al. Retina. 30: , 2010 Gillies MC et al. Invest Ophthalmol Vis Sci. 51: , 2010 Bressler NM et al. Arch Ophthalmol. 127: , 2009 Gillies MC et al. Ophthalmology. 116: , 2009 Aydin E et al. Eur J Ophthalmol. 19: , 2009 Gillies MC et al. Ophthalmology. 116: 591, 2009 Maia OO Jr et al. Am J Ophthalmol. 147: , 2009 Ockrim ZK et al. Br J Ophthalmol. 92: , 2008 Grover D et al. Cochrane Database Syst Rev. 23: 1-32, 2008 Kaderli B et al. Int Ophthalmol. 26: , 2005 Lam DS et al. Br J Ophthalmol. 91: , 2007 Gillies MC et al. Ophthalmology. 113: , 2006 Cardillo JA et al. Ophthalmology. 112: , 2005 Karacorlu M et al. Eye. 19: , 2005 Goyal S et al. Graefes Arch Clin Exp Ophthalmol. 249: 15-27, 2011 Spandau UH et al. Br J Ophthalmol. 89: , 2005 Bae JS et al. Korean J Ophthalmol. 23: 80-85, 2009 Lam DS et al. Br J Ophthalmol. 91: , 2007 Figueroa MS et al. Retina. 28: ,
17 mg mg 4 mg (100) (100) (100) (94.1) (97.0) (100) (84.8) (91.2) (75.0) 34 21(61.8) (25.8) (52.9) (9.1) 34 6 (17.6) % % 8 mg (8 ) 4 mg (18 ) 8 mg (23 ) 4 mg (16 ) 3 (37.5) 7 (38.9) 9 (39.1) 4 (25.0) 1 (12.5) 2 (11.1) 1 (4.3) 2 (12.5) 1 (12.5) (5.6) (8.7) (4.3) (5.6) 1 (4.3) 0 2 (25.0) 2 (11.1) 3 (13.0) 2 (12.5) 1 (12.5) 1 (5.6) 4 (17.4) 1 (6.3) 0 2 (11.1) 6 (26.1) 1 (6.3) 1 (12.5) 4 (22.2) 4 (17.4) 4 (25.0) / mg 2 60 QOL quality of life 2 16
18 .. 9: 63-66, 2006 Toda J et al. Diabetes Res Clin Pract. 84: e38-e40, 2009 / / % 10/100 1 mg 1/11 4 mg 5/45 8 mg 4/ mg 1 8 mg 1 12 HbA1c HbA1c mg 4 mg 1 mg 1001 (11 ) 4002 (33 ) (44 ) 1001 (11 ) 4002 (34 ) (45 ) 1001 (11 ) 4002 (33 ) * 1 (9.1) 3 (9.1) 4 (9.1) 2 (18.2) 3 (8.8) 5 (11.1) 1 (9.1) 0 1 (9.1) 3 (9.1) 4 (9.1) 2 (18.2) 3 (8.8) 5 (11.1) 1 (9.1) % * ± HbA1c 7.0% 8 mg 5.1± mg 5.1± ± HbA1c 7.0% 8 mg 3.9± mg 6.2± ±
19 / /33 3 Diabetic Retinopathy Clinical Research Network. Ophthalmology. 115: , 2008 Diabetic Retinopathy Clinical Research Network. Arch Ophthalmology. 127: , mg 1 / 4002 / Diabetic Retinopathy Clinical Research Network. Ophthalmology. 115: , 2008 Diabetic Retinopathy Clinical Research Network. Arch Ophthalmology. 127: , mg 2 3 Elman MJ et al. Ophthalmology. 117: , Wang YS et al. Chin Med J. 124: , 2011 Gillies MC et al. Ophthalmology. 118: , 2011 Gillies MC et al. Clin Experiment Ophthalmol. 38: , 2010 Elman MJ et al. Ophthalmology. 117: , 2010 Gillies MC et al. Invest Ophthalmol Vis Sci. 51: , 2010 Gillies MC et al. Ophthalmology. 116: , 2009 Soheilian M et al. Ophthalmology. 116: , 2009 Diabetic Retinopathy Clinical Research Network. Ophthalmology. 115: , 2008 Beck RW et al. Arch Ophthalmol. 127: , 2009 Ockrim ZK et al. Br J Ophthalmol. 92: , 2008 Gillies MC et al. Ophthalmology. 113: , 2006 Avci R et al. Clin Experiment Ophthalmol. 34: 27-32, 2006 Ozdemir H et al. Am J Ophthalmol. 140: , 2005 Negi AK et al. Eye. 19: , 2005 Karacorlu M et al. Eye. 19: , 2005 Jonas JB et al. Arch Ophthalmol. 121: 57-61, 2003 Martidis A et al. Ophthalmology. 109: , Gillies MC et al. Ophthalmology. 118: , 2011 Gillies MC et al. Clin Experiment Ophthalmol. 38: , 2010 Elman MJ et al. Ophthalmology. 117: , 2010 Gillies MC et al. Ophthalmology. 116: , 2009 Diabetic Retinopathy Clinical Research Network. Ophthalmology. 115: , 2008 Beck RW et al. Arch Ophthalmol. 127: , 2009 Gillies MC et al. Ophthalmology. 113: ,
20 Ophthalmol. 38: , 2010 Ophthalmol. 145: , 2008 Gillies MC et al. Clin Experiment.. 26: , 2009 Inatani M et al. Am J 4 4 mg 8 mg 4 mg / mg 8 mg mg mg 2 4 mg 5 FAG Otani T and Kishi S. Ophthalmology. 114: , 2007 OCT Otani T et al. Am J Ophthalmol. 127: , 1999 FAG ,
21 VEGF.. 28: , : , : , , GCP 20
22 GCP. 21
23 mg / : , / mg ng/ml ng/ml
24 ml 10 mg/ml mg ml 40 mg/ml 1 1mL 4mg 40 mg/ml 0.1 ml 23
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