玻璃体内抗血管内皮生长因子治疗与光动力疗法治疗特发性脉络膜新生血管。

Intravitreal anti-vascular endothelial growth factor therapy versus photodynamic therapy for idiopathic choroidal neovascularization.

机构信息

Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

Am J Ophthalmol. 2013 Apr;155(4):713-9, 719.e1. doi: 10.1016/j.ajo.2012.10.010. Epub 2012 Dec 7.

DOI:10.1016/j.ajo.2012.10.010

PMID:23219069

Abstract

PURPOSE

To compare visual outcomes after intravitreal anti-vascular endothelial growth factor (VEGF) injection or photodynamic therapy (PDT) for idiopathic choroidal neovascularization (CNV).

DESIGN

Retrospective study.

METHODS

Among 29 eyes (28 patients), 15 eyes (15 patients) received anti-VEGF therapy and 14 eyes (13 patients) received PDT. Best-corrected visual acuity (BCVA, logMAR [logarithm of minimal angle of resolution]) at baseline and 1, 3, 6, 12, and 24 months after initial treatment were compared. The eyes were classified by BCVA changes: improved (improvement ≥0.3 logMAR), decreased (deterioration ≥0.3 logMAR), and stable.

RESULTS

Mean BCVA was 0.56 ± 0.38 logMAR (20/72 in Snellen equivalent) in the PDT group and 0.44 ± 0.59 logMAR (20/55 in Snellen equivalent) in the anti-VEGF group at baseline (P = .104, Mann-Whitney U test). The anti-VEGF group showed significantly better mean BCVA at each follow-up visit when compared with that of PDT (P = .004 at 1 month, P = .002 at 3 months, P = .037 at 6 months, P = .031 at 12 months, and P = .049 at 24 months; Mann-Whitney U test, respectively). When compared with the baseline, mean BCVA at each follow-up visit was better in the anti-VEGF group (P = .196 at 1 month, P = .007 at 3 months, P = .046 at 6 months, P = .046 at 12 months, and P = .049 at 24 months; Wilcoxon signed rank test, respectively), whereas BCVA in the PDT group was not. At 24 months, all eyes (100.0%) treated with anti-VEGF showed stable or improved BCVA, whereas 3 eyes (21.3%) showed visual deterioration after PDT.

CONCLUSIONS

Anti-VEGF therapy was superior to PDT for idiopathic CNV, and superior efficacy was sustained until 24 months.

摘要

目的

比较特发性脉络膜新生血管（CNV）患者玻璃体内抗血管内皮生长因子（VEGF）注射与光动力疗法（PDT）的视力结果。

设计

回顾性研究。

方法

29 只眼（28 例患者）中，15 只眼（15 例患者）接受抗 VEGF 治疗，14 只眼（13 例患者）接受 PDT。比较初始治疗后 1、3、6、12 和 24 个月的最佳矫正视力（BCVA，logMAR [最小分辨角对数]）。根据 BCVA 变化对眼睛进行分类：改善（提高≥0.3 logMAR）、恶化（恶化≥0.3 logMAR）和稳定。

结果

PDT 组平均 BCVA 为 0.56 ± 0.38 logMAR（20/72 视力表等价物），抗 VEGF 组为 0.44 ± 0.59 logMAR（20/55 视力表等价物）（P=.104，Mann-Whitney U 检验）。与 PDT 相比，抗 VEGF 组在每次随访时的平均 BCVA 均显著更好（1 个月时 P=.004，3 个月时 P=.002，6 个月时 P=.037，12 个月时 P=.031，24 个月时 P=.049；Mann-Whitney U 检验）。与基线相比，抗 VEGF 组在每次随访时的平均 BCVA 均更好（1 个月时 P=.196，3 个月时 P=.007，6 个月时 P=.046，12 个月时 P=.046，24 个月时 P=.049；Wilcoxon 符号秩检验），而 PDT 组则不然。24 个月时，所有接受抗 VEGF 治疗的眼睛（100.0%）均表现出稳定或改善的 BCVA，而 PDT 治疗后 3 只眼睛（21.3%）出现视力恶化。