Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
Am J Ophthalmol. 2013 Apr;155(4):713-9, 719.e1. doi: 10.1016/j.ajo.2012.10.010. Epub 2012 Dec 7.
To compare visual outcomes after intravitreal anti-vascular endothelial growth factor (VEGF) injection or photodynamic therapy (PDT) for idiopathic choroidal neovascularization (CNV).
Retrospective study.
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.
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.
Anti-VEGF therapy was superior to PDT for idiopathic CNV, and superior efficacy was sustained until 24 months.
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。
回顾性研究。
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。
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。
抗 VEGF 治疗在特发性 CNV 方面优于 PDT，并且疗效持续至 24 个月。
