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抗血管内皮生长因子治疗与未治疗的新生血管性年龄相关性黄斑变性患者脉络膜的增强深度成像。

Enhanced depth imaging of the choroid in patients with neovascular age-related macular degeneration treated with anti-VEGF therapy versus untreated patients.

机构信息

Medical Retina Service, Moorfields Eye Hospital, London, UK.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2013 Jun;251(6):1483-8. doi: 10.1007/s00417-012-2199-x. Epub 2012 Nov 17.

Abstract

PURPOSE

To compare the subfoveal choroidal thickness (SFCT) between patients with neovascular age-related macular degeneration (nAMD) who had multiple intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents and those with treatment-naïve nAMD.

METHODS

This retrospective case-control study included 15 patients in group 1 (nAMD in one eye which had received at least three anti-VEGF injections and early AMD in the fellow eye) and 15 patients in group 2 (newly diagnosed nAMD in one eye which had not received any treatment and early AMD in the fellow eye). They underwent enhanced depth imaging optical coherence tomography (OCT), and two OCT readers manually measured the SFCT. Inter-ocular difference in SFCT (nAMD eye minus fellow eye) was calculated for each patient.

RESULTS

The nAMD eyes in group 1 had received a median (range) of four (3-8) intravitreal injections of anti-VEGF agents, and the OCT scans were performed at a median (range) of 9 (4-17) months after the first injection. The median inter-ocular difference in SFCT in groups 1 and 2 were not significantly different (13.5 and 3.0 μm in groups 1 and 2 respectively, p=0.60). There was also no statistically significant difference in SFCT between nAMD and fellow eyes (p=0.16), although there was a trend for greater median SFCT in the nAMD eyes.

CONCLUSION

The data from this small cohort suggests that no gross reduction in SFCT appears in nAMD patients after a time interval of at least 4 months between initiating repeated treatment with anti-VEGF therapy and OCT imaging. However, a study with a much larger sample size or longitudinal design is required to detect possible small fluctuations in SFCT in nAMD eyes receiving anti-VEGF therapy.

摘要

目的

比较接受多次抗血管内皮生长因子(anti-VEGF)治疗的新生血管性年龄相关性黄斑变性(nAMD)患者与未经治疗的 nAMD 患者的中心凹下脉络膜厚度(SFCT)。

方法

本回顾性病例对照研究纳入了 15 名组 1 患者(一眼患有 nAMD,已接受至少三次抗 VEGF 治疗,对侧眼为早期 AMD)和 15 名组 2 患者(一眼新诊断为 nAMD,未经任何治疗,对侧眼为早期 AMD)。所有患者均接受增强深度成像光学相干断层扫描(OCT)检查,两名 OCT 阅读器手动测量 SFCT。每位患者计算 SFCT 的眼间差异(nAMD 眼减去对侧眼)。

结果

组 1 的 nAMD 眼接受了中位数(范围)为 4(3-8)次抗 VEGF 治疗,OCT 扫描在首次注射后中位数(范围)为 9(4-17)个月进行。组 1 和 2 的 SFCT 眼间差异中位数无显著差异(分别为 13.5 和 3.0μm,p=0.60)。nAMD 眼和对侧眼的 SFCT 也无统计学差异(p=0.16),尽管 nAMD 眼的 SFCT 中位数有增大趋势。

结论

该小队列数据表明,在重复抗 VEGF 治疗与 OCT 成像之间至少间隔 4 个月的时间后,nAMD 患者的 SFCT 并未明显减少。但是,需要进行更大样本量或纵向设计的研究,以检测接受抗 VEGF 治疗的 nAMD 眼 SFCT 可能存在的微小波动。

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