Bressler Neil M, Doan Quan V, Varma Rohit, Lee Paul P, Suñer Ivan J, Dolan Chantal, Danese Mark D, Yu Elaine, Tran Irwin, Colman Shoshana
Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Arch Ophthalmol. 2011 Jun;129(6):709-17. doi: 10.1001/archophthalmol.2011.140.
To estimate the number of non-Hispanic white individuals in the United States avoiding legal blindness and visual impairment from neovascular age-related macular degeneration (AMD) with ranibizumab availability.
Modeling of visual acuity outcomes from phase 3 ranibizumab trials to incidence rates of neovascular AMD from population-based studies.
If no treatment were given, of the 103 582 individuals developing neovascular AMD for which ranibizumab would be indicated and available, 16 268 would become legally blind in 2 years. Monthly ranibizumab would reduce the incidence of legal blindness in 2 years by 72% (95% confidence interval [CI], 70% to 74%) to 4484 individuals. If no treatment were given, 34 702 would become visually impaired. Monthly ranibizumab would reduce the incidence of visual impairment in 2 years by 37% (95% CI, 35% to 39%) to 21 919 cases.
Ranibizumab should have a substantial effect on reducing the magnitude of legal blindness and visual impairment within 2 years after diagnosis of neovascular AMD among non-Hispanic white individuals in the United States. Although racial subgroups other than non-Hispanic whites were not considered (because there is limited information in the literature regarding incidence rates of choroidal neovascularization in other populations) and although these results assume access to and application of monthly ranibizumab for 2 years, the number of individuals developing legal blindness or vision impairment from neovascular AMD should be reduced dramatically if monthly ranibizumab is applied when indicated.
评估在美国有雷珠单抗可用的情况下，避免因新生血管性年龄相关性黄斑变性（AMD）导致法定失明和视力损害的非西班牙裔白人个体数量。
将雷珠单抗3期试验的视力结果建模为基于人群研究的新生血管性AMD发病率。
如果不进行治疗，在103582例适合且有雷珠单抗可用的新生血管性AMD患者中，16268例将在2年内发展为法定失明。每月注射雷珠单抗可使2年内法定失明的发生率降低72%（95%置信区间[CI]，70%至74%），降至4484例。如果不进行治疗，34702例将出现视力损害。每月注射雷珠单抗可使2年内视力损害的发生率降低37%（95%CI，35%至39%），降至21919例。
在美国非西班牙裔白人个体中，雷珠单抗对降低新生血管性AMD诊断后2年内法定失明和视力损害的程度应具有显著效果。尽管未考虑非西班牙裔白人以外的种族亚组（因为文献中关于其他人群脉络膜新生血管发生率的信息有限），并且尽管这些结果假设在2年内每月都能获得并应用雷珠单抗，但如果在有指征时每月应用雷珠单抗，因新生血管性AMD导致法定失明或视力损害的个体数量应会大幅减少。
