Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea; Department of Ophthalmology, International St. Mary's Hospital, Incheon, South Korea.
Department of Ophthalmology, Bundang Cha General Hospital, CHA University, Gyunggi-do, South Korea.
Am J Ophthalmol. 2014 May;157(5):1013-21. doi: 10.1016/j.ajo.2014.01.019. Epub 2014 Jan 30.
To investigate the prognostic implication of subfoveal choroidal thickness on treatment outcome after intravitreal ranibizumab injections for typical exudative age-related macular degeneration (AMD).
Retrospective study.
A total of 40 eyes of 37 patients who completed 6-month follow-up were analyzed. Patients' data were retrieved from medical records including best-corrected visual acuity (BCVA). Subfoveal choroidal thickness at baseline, 3 months, and 6 months was measured by enhanced depth imaging optical coherence tomography and adjusted for age and sex before statistical analysis. Treatment response was after 3 monthly intravitreal ranibizumab injections. Responders (responder group) were defined as a 100 μm or more decrease or complete resolution of subretinal fluid, whereas nonresponders (nonresponder group) were defined as changes less than 100 μm or more than 100 μm increase of subretinal fluid by optical coherence tomography.
Mean age at diagnosis was 72.1 ± 8.1 years, and 22 eyes (55.0%) were responders. The responder group had thicker subfoveal choroid (257.2 ± 108.3 μm) and smaller lesions (1.3 ± 0.8 μm) at baseline than the nonresponder group (167.1 ± 62.4 μm, P = .003; and 2.0 ± 1.0 μm, P = .008). The responder group showed significantly better BCVA and thicker subfoveal choroid than the nonresponder group at 3 months (P = .002 and P = .023) and 6 months (P = .004 and P = .031). Stepwise and binary regression analysis demonstrated that subfoveal choroidal thickness was significantly correlated with visual outcome (B = -0.002, P = .003) and treatment response (B = 8.136, P = .018).
Subfoveal choroidal thickness may be a predictive factor for visual outcome and treatment response in typical exudative AMD after intravitreal ranibizumab injections.
研究脉络膜厚度对接受玻璃体内雷珠单抗注射治疗的典型渗出性年龄相关性黄斑变性(AMD)患者的治疗效果的预后意义。
回顾性研究。
对完成 6 个月随访的 37 例 40 只眼患者的数据进行分析。从病历中提取患者的最佳矫正视力(BCVA)等数据。应用增强深度成像光学相干断层扫描(OCT)测量基线、3 个月和 6 个月时的脉络膜厚度,并在进行统计分析前根据年龄和性别进行校正。以 3 个月时的玻璃体腔内雷珠单抗注射为治疗应答时间点。将 BCVA 提高 100μm 或以上,或完全消除视网膜下积液定义为应答者(应答组),将 BCVA 提高不足 100μm 或增加 100μm 以上定义为非应答者(非应答组)。
诊断时的平均年龄为 72.1±8.1 岁,22 只眼(55.0%)为应答者。与非应答者相比,应答者的脉络膜厚度更厚(257.2±108.3μm 比 167.1±62.4μm,P=0.003),病灶更小(1.3±0.8μm 比 2.0±1.0μm,P=0.008)。在 3 个月(P=0.002 和 P=0.023)和 6 个月(P=0.004 和 P=0.031)时,应答者的 BCVA 更好,脉络膜厚度更厚。逐步和二元回归分析表明,脉络膜厚度与视力结果(B=-0.002,P=0.003)和治疗应答(B=8.136,P=0.018)显著相关。
脉络膜厚度可能是玻璃体内雷珠单抗治疗典型渗出性 AMD 后视力结果和治疗应答的预测因素。