Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Japan.
Ophthalmologica. 2012;228(2):102-9. doi: 10.1159/000337251. Epub 2012 Apr 13.
To investigate the course of subfoveal pigment epithelial detachments (PEDs) in eyes with age-related macular degeneration (AMD) and best-corrected visual acuity (BCVA) ≥20/40.
Thirty-seven eyes of 35 patients with a subfoveal PED were divided into an avascular PED group (n = 11), a vascularized PED group due to polypoidal choroidal vasculopathy (PCV, n = 14) and an occult choroidal neovascularization (CNV) group (n = 12). Intravitreal bevacizumab or ranibizumab was given as needed. The BCVA, central foveal thickness, PED thickness, and lesion size were measured at baseline and at 2 years after the initial examination.
The BCVA did not change significantly in the avascular group, decreased from 0.06 ± 0.11 to 0.23 ± 0.15 logMAR units in the PCV group and from 0.12 ± 0.12 to 0.71 ± 0.70 logMAR units in the CNV group. At 2 years, the central foveal and PED thicknesses were not significantly different among the 3 groups, and the lesion was significantly larger in the PCV and CNV groups than in the avascular group.
The vascularized PED cases had a poorer visual outcome than avascular PEDs with anti-VEGF drugs at the 2-year follow-up.
研究年龄相关性黄斑变性(AMD)和最佳矫正视力(BCVA)≥20/40 的患者中, 黄斑中心凹下色素上皮脱离(PED)的病程。
35 例黄斑中心凹下PED 的患者 37 只眼,分为无血管PED 组(n=11)、息肉样脉络膜血管病变(PCV)所致的血管化PED 组(n=14)和隐匿性脉络膜新生血管(CNV)组(n=12)。根据需要,眼内注射贝伐单抗或雷珠单抗。在基线和初始检查后 2 年测量 BCVA、中心凹视网膜厚度、PED 厚度和病变大小。
无血管组的 BCVA 无明显变化,PCV 组从 0.06±0.11 降至 0.23±0.15 logMAR 单位,CNV 组从 0.12±0.12 降至 0.71±0.70 logMAR 单位。在 2 年时,3 组的中心凹视网膜和 PED 厚度无显著差异,PCV 和 CNV 组的病变明显大于无血管组。
在抗 VEGF 药物治疗 2 年的随访中,血管化 PED 病例的视力预后比无血管 PED 差。