亚洲年龄相关性黄斑变性和息肉样脉络膜血管病变治疗模式及1年预后的前瞻性研究。
A prospective study of treatment patterns and 1-year outcome of Asian age-related macular degeneration and polypoidal choroidal vasculopathy.
作者信息
Cheung Chui Ming Gemmy, Li Xiang, Mathur Ranjana, Lee Shu Yen, Chan Choi Mun, Yeo Ian, Loh Boon Kwang, Williams Rachel, Wong Edmund Yick-Mun, Wong Doric, Wong Tien Yin
机构信息
Vitreoretinal Service, Singapore National Eye Centre, Singapore, Singapore; Singapore Eye Research Institute, Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Singapore.
Singapore Eye Research Institute, Singapore, Singapore; Department of Statistics and Applied Probability, National University of Singapore, Singapore, Singapore.
出版信息
PLoS One. 2014 Jun 30;9(6):e101057. doi: 10.1371/journal.pone.0101057. eCollection 2014.
OBJECTIVE
To study the treatment patterns and visual outcome over one year in Asian patients with choroidal neovascular membrane secondary to age-related macular degeneration (AMD-CNV) and polypoidal choroidal vasculopathy (PCV).
DESIGN
Prospective cohort, non-interventional study.
METHODS
132 treatment-naïve patients who received treatment for AMD-CNV and PCV were included. All patients underwent standardized examination procedures including retinal imaging at baseline and follow-up. AMD-CNV and PCV were defined on fundus fluorescein angiography and indocyanine green angiography at baseline. Patients were treated according to standard of care.We report the visual acuity (VA) and optical coherence tomography (OCT) measurements at baseline, month 3 and month 12 The factors influencing month 12 outcomes were analyzed.
MAIN OUTCOME MEASURE
Type of treatment, number of Anti-vascular endothelial growth factor (VEGF) treatments, visual outcome over one year.
RESULTS
Anti-VEGF monotherapy was the initial treatment in 89.1% of AMD-CNV, but only 15.1% of PCV. The mean number of anti-VEGF injections up to month 12 was 3.97 (4.51 AMD-CNV, 3.43 PCV, p = 0.021). Baseline OCT, month 3 OCT and month 3 VA were significant in determining continuation of treatment after month 3. At month 12, mean VA improved from 0.82 (∼20/132) at baseline to 0.68 (∼20/96) at month 12 (mean gain 6.5 ETDRS letters, p = 0.002). 34.2% of eyes (38/113 eyes) gained ≥15 ETDRS letters and 14.4% (16/113 eyes) lost ≥15 ETDRS letters. There were no significant differences in visual outcome between AMD-CNV and PCV (p = 0.51). Factors predictive of month 12 visual outcome were baseline VA, baseline OCT central macular thickness, month 3 VA and age.
CONCLUSIONS
There is significant variation in treatment patterns in Asian eyes with exudative maculopathy. There is significant visual improvement in all treatment groups at one year. These data highlight the need for high quality clinical trial data to provide evidence-based management of Asian AMD.
目的
研究亚洲年龄相关性黄斑变性继发脉络膜新生血管（AMD-CNV）和息肉状脉络膜血管病变（PCV）患者一年中的治疗模式和视力转归。
设计
前瞻性队列、非干预性研究。
方法
纳入132例初治的AMD-CNV和PCV患者。所有患者在基线期和随访时均接受包括视网膜成像在内的标准化检查程序。根据基线期的眼底荧光血管造影和吲哚菁绿血管造影来定义AMD-CNV和PCV。患者按标准治疗方案进行治疗。我们报告了基线期、第3个月和第12个月时的视力（VA）和光学相干断层扫描（OCT）测量结果。分析影响第12个月转归的因素。
主要观察指标
治疗类型、抗血管内皮生长因子（VEGF）治疗次数、一年中的视力转归。
结果
抗VEGF单药治疗是89.1%的AMD-CNV患者的初始治疗方法，但在PCV患者中仅为15.1%。至第12个月时抗VEGF注射的平均次数为3.97次（AMD-CNV为4.51次，PCV为3.43次，p = 0.021）。基线期OCT、第3个月OCT和第3个月VA在决定第3个月后是否继续治疗方面具有显著意义。在第12个月时，平均视力从基线期的0.82（约20/132）提高到第12个月时的0.68（约20/96）（平均提高6.5个ETDRS字母，p = 0.002）。34.2%的眼（38/113只眼）提高了≥15个ETDRS字母，14.4%（16/113只眼）降低了≥15个ETDRS字母。AMD-CNV和PCV之间的视力转归无显著差异（p = 0.51）。预测第12个月视力转归的因素为基线期VA、基线期OCT中心黄斑厚度、第3个月VA和年龄。
结论
亚洲渗出性黄斑病变患者的治疗模式存在显著差异。所有治疗组在一年时视力均有显著改善。这些数据凸显了需要高质量的临床试验数据来为亚洲AMD的循证管理提供依据。
Zotero 插件