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单独玻璃体内贝伐单抗与联合维替泊芬光动力疗法和玻璃体内贝伐单抗治疗年龄相关性黄斑变性脉络膜新生血管: 1 年随访后的视力

Intravitreal bevacizumab alone versus combined verteporfin photodynamic therapy and intravitreal bevacizumab for choroidal neovascularization in age-related macular degeneration: visual acuity after 1 year of follow-up.

机构信息

Department of Ophthalmology, University of Alberta, Alberta, Canada.

出版信息

Retina. 2010 Apr;30(4):548-54. doi: 10.1097/IAE.0b013e3181bcf1b8.

Abstract

PURPOSE

The purpose of the study was to compare the mean change in visual acuity between bevacizumab and combined bevacizumab and photodynamic therapy for the treatment of choroidal neovascularization from age-related macular degeneration after 12 months of follow-up.

METHODS

This study included a retrospective cohort of patients with untreated choroidal neovascularization. The generalized estimating equation was used to account for the correlation between eyes and to construct multivariate models to control for confounding factors of visual acuity change.

RESULTS

One hundred and thirty-nine eyes treated with bevacizumab were compared with 236 eyes that received bevacizumab and photodynamic therapy (combination treatment). The monotherapy eyes showed an improvement of 0.101 +/- 0.619 logarithm of minimum angle of resolution units (5.05 letters) after a mean follow-up of 409.6 days versus 0.096 +/- 0.611 (4.8 letters) after a mean follow-up of 416.7 days with combination therapy; there was no difference between the groups (P = 0.970). The monotherapy eyes received 3.32 +/- 1.71 injections versus 3.14 +/- 1.52 injections in the combination therapy group (P = 0.665). The multivariate analysis did not show any difference between groups at the end of the study period in terms of visual improvement, worsening, stabilization, or the number of bevacizumab injections used.

CONCLUSION

Long-term visual outcomes for the treatment of choroidal neovascularization in age-related macular degeneration are not improved with the addition of photodynamic therapy to bevacizumab nor are fewer injections needed.

摘要

目的

本研究旨在比较贝伐单抗与贝伐单抗联合光动力疗法治疗年龄相关性黄斑变性脉络膜新生血管 12 个月后视力平均变化。

方法

本研究纳入了未经治疗的脉络膜新生血管患者的回顾性队列。使用广义估计方程来解释眼睛之间的相关性,并构建多变量模型来控制视力变化的混杂因素。

结果

139 只接受贝伐单抗治疗的眼睛与 236 只接受贝伐单抗联合光动力疗法(联合治疗)的眼睛进行了比较。单药治疗组在平均随访 409.6 天后的最小角度分辨率对数单位(5.05 个字母)改善了 0.101 +/- 0.619,而在平均随访 416.7 天后的改善了 0.096 +/- 0.611(4.8 个字母);两组之间没有差异(P = 0.970)。单药治疗组接受了 3.32 +/- 1.71 次注射,而联合治疗组接受了 3.14 +/- 1.52 次注射(P = 0.665)。多变量分析显示,在研究结束时,两组在视力改善、恶化、稳定或使用贝伐单抗注射次数方面均无差异。

结论

在年龄相关性黄斑变性脉络膜新生血管的治疗中,添加光动力疗法并不能改善长期视觉结局,也不需要减少贝伐单抗的注射次数。

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