Department of Ophthalmology, Grampian University Hospital-NHS Trust, Aberdeen, Scotland, UK.
Retina. 2013 Jan;33(1):13-22. doi: 10.1097/IAE.0b013e3182657fff.
To evaluate the occurrence of retinal pigment epithelial atrophy in patients with age-related macular degeneration undergoing anti-vascular endothelial growth factor therapy.
The study is a retrospective review. Eligible were patients with age-related macular degeneration and choroidal neovascular membranes treated with anti-vascular endothelial growth factor between October 2007 and February 2011; they were followed for >3 months, with fundus photographs and fluorescein angiography at baseline and with autofluorescence and near-infrared autofluorescence images at baseline and follow-up. Demographics, visual acuity, the type of choroidal neovascular membranes, the number of treatments performed, and the length of follow-up were recorded. Autofluorescence and near-infrared autofluorescence images were evaluated for the presence or absence of areas of reduced signal. A multilevel logistic regression model was used to investigate the factors that may be associated with "progression of atrophy" at follow-up, which was the primary outcome of this study.
Sixty-three patients (72 eyes) were followed for a median of 16 months (range, 3-36 months). Atrophy at baseline was observed in 47% (34/72) of eyes; progression of atrophy occurred in 62% (45/72) of eyes at the last visit. The number of anti-vascular endothelial growth factor injections received was statistically significantly associated with the progression of atrophy at follow-up (odds ratio, 1.35; 95% confidence interval, 1.05-1.73; P = 0.02).
Atrophy was frequently observed in patients with age-related macular degeneration and choroidal neovascular membranes undergoing anti-vascular endothelial growth factor therapy.
评估接受抗血管内皮生长因子治疗的年龄相关性黄斑变性患者中视网膜色素上皮萎缩的发生情况。
本研究为回顾性研究。纳入标准为 2007 年 10 月至 2011 年 2 月期间接受抗血管内皮生长因子治疗的年龄相关性黄斑变性合并脉络膜新生血管的患者；随访时间＞3 个月，基线时行眼底照相和荧光素眼底血管造影，随访时行自发荧光和近红外自发荧光检查。记录患者的一般资料、视力、脉络膜新生血管的类型、治疗次数和随访时间。评估自发荧光和近红外自发荧光图像是否存在信号减弱区域。采用多水平逻辑回归模型分析可能与随访时“萎缩进展”相关的因素，这是本研究的主要结局。
63 例患者（72 只眼）的中位随访时间为 16 个月（范围 3-36 个月）。基线时已有 47%（34/72）的眼存在萎缩，末次随访时 62%（45/72）的眼发生萎缩进展。抗血管内皮生长因子注射次数与随访时的萎缩进展显著相关（比值比，1.35；95%置信区间，1.05-1.73；P=0.02）。
接受抗血管内皮生长因子治疗的年龄相关性黄斑变性合并脉络膜新生血管患者常出现萎缩。
