Kojima Ariko, Ohno-Matsui Kyoko, Teramukai Satoshi, Ishihara Yoko, Shimada Noriaki, Yoshida Takeshi, Sugamoto Yoshiharu, Tokoro Takashi, Mochizuki Manabu
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Tokyo 113-8519, Japan.
Graefes Arch Clin Exp Ophthalmol. 2006 Nov;244(11):1474-9. doi: 10.1007/s00417-006-0324-4. Epub 2006 Apr 21.
To clarify prognostic factors of long-term visual outcome without treatment in patients with myopic choroidal neovascularization (CNV) and estimate a regression equation to predict visual acuity at 5 years after CNV onset.
Fifty-four eyes of 54 consecutive patients with high myopia and subfoveal CNV who did not receive treatment were identified using clinical records from 1988 to 2004. Photodynamic therapy not approved for myopic CNV in Japan during this period. The association of best-corrected visual acuity (BCVA) at 5 years after CNV onset with patient age, refractive error, axial length, initial BCVA, myopic retinopathy grade, duration of persistent hemorrhage, CNV size at onset, and size of hemorrhage around the CNV was analyzed using Spearman's correlation and multiple linear regression analysis.
BCVA at 5 years after onset was significantly associated with patient age, CNV size, and initial BCVA (P<0.05, Spearman's correlation). The regression equation estimating BCVA at 5 years after CNV onset was based on age and initial BCVA (R2=0.43). When subjects were divided into groups according to age (<40 and >or=40 years), CNV size, axial length and duration of persistent hemorrhage influenced BCVA at 5 years in patients under 40 years; while only initial BCVA was an influence in those at least 40 years old.
We developed a linear predictive model to estimate BCVA at 5 years after onset of myopic CNV without treatment based on the identified prognostic factors. This information might be important for managing patients with myopic CNV.
明确高度近视性脉络膜新生血管（CNV）患者未经治疗的长期视力预后因素，并估计一个回归方程以预测CNV发病后5年的视力。
利用1988年至2004年的临床记录，确定54例连续的高度近视和黄斑中心凹下CNV且未接受治疗的患者的54只眼。在此期间，光动力疗法在日本未被批准用于高度近视性CNV。使用Spearman相关性分析和多元线性回归分析，分析CNV发病后5年的最佳矫正视力（BCVA）与患者年龄、屈光不正、眼轴长度、初始BCVA、近视性视网膜病变分级、持续性出血持续时间、CNV发病时大小以及CNV周围出血大小之间的关联。
发病后5年的BCVA与患者年龄、CNV大小和初始BCVA显著相关（P<0.05，Spearman相关性）。估计CNV发病后5年BCVA的回归方程基于年龄和初始BCVA（R2=0.43）。当根据年龄（<40岁和≥40岁）分组时，CNV大小、眼轴长度和持续性出血持续时间影响40岁以下患者发病后5年的BCVA；而对于至少40岁的患者，只有初始BCVA有影响。
我们基于已确定的预后因素，建立了一个线性预测模型，以估计未经治疗的高度近视性CNV发病后5年的BCVA。这些信息对于管理高度近视性CNV患者可能很重要。
