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贝伐单抗治疗新生血管性年龄相关性黄斑变性的视力和解剖学预后的预测因素。

Predictors of visual and anatomical outcomes for neovascular age-related macular degeneration treated with bevacizumab.

作者信息

Ma Chaoran, Bai Liang, Lei Chunling, Wu Changrui, Shi Qiang, Hu Feng, Hao Zhenxuan, Ma L E

机构信息

Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.

The Fourth Hospital of Xi'an, Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China.

出版信息

Biomed Rep. 2015 Jul;3(4):503-508. doi: 10.3892/br.2015.448. Epub 2015 Apr 16.

Abstract

The present study aimed to evaluate the predictive factors for visual and anatomical outcomes in neovascular age-related macular degeneration (AMD) patients treated with intravitreal bevacizumab (IVB). A total of 113 patients with neovascular AMD received IVB treatment. The best corrected visual acuity (BCVA), central retinal thickness (CRT) and total macular volume (TMV) were assessed before the injection, and at 1, 2, 3 and 9 months after surgery. Changes in BCVA and these optical coherence tomography (OCT) outcomes from baseline were compared, and independent predictors were evaluated by logistic regression models. During the treatment, logarithm of the minimum angle of resolution (logMAR) significantly decreased from 1.12 to 0.83, and reductions in OCT parameters were earlier and larger. Baseline BCVA was associated with the changes in BCVA and CRT, whereas baseline OCT features significantly affected their own changes. Larger baseline logMAR and OCT features were more likely to experience a greater proportion of ≥50 µm reduction in CRT (P<0.05). The BCVA decreases were positively associated with the reductions in CRT (r=0.34, P<0.01) and TMV (r=0.41, P<0.01). Among patients with neovascular AMD, IVB resulted in earlier significant decreases in TMV and CRT, suggesting that these OCT anatomical outcomes may be considered as more sensitive responders to evaluate the treatment effects of bevacizumab.

摘要

本研究旨在评估玻璃体内注射贝伐单抗(IVB)治疗的新生血管性年龄相关性黄斑变性(AMD)患者视觉和解剖学预后的预测因素。共有113例新生血管性AMD患者接受了IVB治疗。在注射前以及术后1、2、3和9个月评估最佳矫正视力(BCVA)、视网膜中央厚度(CRT)和黄斑总体积(TMV)。比较BCVA以及这些光学相干断层扫描(OCT)结果相对于基线的变化,并通过逻辑回归模型评估独立预测因素。在治疗期间,最小分辨角对数(logMAR)从1.12显著降至0.83,OCT参数的降低更早且幅度更大。基线BCVA与BCVA和CRT的变化相关,而基线OCT特征显著影响其自身变化。基线logMAR和OCT特征越大,CRT降低≥50 µm的比例越高(P<0.05)。BCVA降低与CRT(r=0.34,P<0.01)和TMV(r=0.41,P<0.01)的降低呈正相关。在新生血管性AMD患者中,IVB导致TMV和CRT更早出现显著降低,这表明这些OCT解剖学结果可能被视为评估贝伐单抗治疗效果更敏感的反应指标。

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