Centre Ophtalmologique d'Imagerie et de Laser, Paris, France.
Graefes Arch Clin Exp Ophthalmol. 2011 Apr;249(4):521-7. doi: 10.1007/s00417-010-1553-0. Epub 2010 Nov 6.
Age-related macular degeneration is the primary cause of blindness in developed countries. Current treatments of this degenerative disease mainly include laser, photodynamic therapy with verteporfin and administration of anti-vascular endothelial growth factors. The LUEUR (LUcentis® En Utilisation Réelle) study is composed of a cross-sectional part (LUEUR1), which examined the current management of wet AMD in France, and a follow-up part (LUEUR2), which will assess the development of patients treated for wet AMD over 4 years. Here we describe the results of LUEUR1.
Patients with wet AMD were enrolled during a routine medical examination in LUEUR1, a cross-sectional, observational, prospective, multicentre study. Investigators recorded patient demographics, visual acuity, characteristics of wet AMD lesions, date of AMD diagnosis, comorbidities, previous treatments, treatments prescribed at inclusion, and low vision rehabilitation.
A total of 72 investigators recruited 1,019 patients with wet AMD, corresponding to 1,405 eyes affected by the disease. The mean age of patients was 78.7 ± 7.3 years. Most were female (62.3%) and non-smokers (66.9%). The mean visual acuity was 49.12 ± 24.18 Early Treatment Diabetic Retinopathy Study letters. Most eyes showed occult (52.8%) and subfoveal (84.6%) choroidal neovascularisation. Bilateral wet AMD affected 37.9% of patients. The median time since diagnosis was 12 months. Ranibizumab-based therapy (67.3%) and photodynamic therapy (29.8%) were the most frequent previous treatments. Prior to inclusion, 5.6% of patients had low vision rehabilitation. When a treatment was prescribed on the day of inclusion, it was most often ranibizumab (89.0% of all treatments at inclusion).
The results of this study illustrate the impact of anti-vascular endothelial growth factor therapies on the treatment of wet AMD in a real-life context. Specifically, ranibizumab-based therapy appears to have largely replaced laser photocoagulation and verteporfin-based photodynamic therapy.
年龄相关性黄斑变性是发达国家失明的主要原因。目前,这种退行性疾病的主要治疗方法包括激光、维替泊芬光动力疗法和抗血管内皮生长因子治疗。LUEUR(LUcentis® En Utilisation Réelle)研究由横断面部分(LUEUR1)和随访部分(LUEUR2)组成,前者调查了法国湿性年龄相关性黄斑变性的当前治疗方法,后者将评估 4 年内接受湿性年龄相关性黄斑变性治疗的患者的病情进展。此处我们描述了 LUEUR1 的结果。
LUEUR1 为一项横断面、观察性、前瞻性、多中心研究,在常规医疗检查中招募湿性年龄相关性黄斑变性患者。研究者记录了患者的人口统计学特征、视力、湿性年龄相关性黄斑变性病变特征、年龄相关性黄斑变性诊断日期、合并症、既往治疗、纳入时的治疗方案和低视力康复情况。
共有 72 名研究者招募了 1019 名湿性年龄相关性黄斑变性患者,共 1405 只患病眼。患者的平均年龄为 78.7±7.3 岁,女性占 62.3%,非吸烟者占 66.9%。平均视力为 49.12±24.18 Early Treatment Diabetic Retinopathy Study 字母。大多数眼为隐匿性(52.8%)和中心凹下(84.6%)脉络膜新生血管。37.9%的患者为双眼湿性年龄相关性黄斑变性。诊断后中位时间为 12 个月。基于雷珠单抗的治疗(67.3%)和光动力疗法(29.8%)是最常见的既往治疗。纳入前,5.6%的患者已行低视力康复。纳入当天开具的治疗中,最常使用的是雷珠单抗(所有纳入时治疗的 89.0%)。
该研究结果说明了抗血管内皮生长因子治疗在真实环境中对湿性年龄相关性黄斑变性治疗的影响。具体而言,基于雷珠单抗的治疗似乎已基本取代了激光光凝和维替泊芬光动力疗法。