Or Chris, Chui Lica, Fallah Nader, Forooghian Farzin
Departments of *Ophthalmology, and †Medicine, University of British Columbia, Vancouver, BC, Canada.
Retina. 2016 Feb;36(2):264-71. doi: 10.1097/IAE.0000000000000795.
To determine baseline factors that can predict the response of pigment epithelial detachments (PEDs) in neovascular age-related macular degeneration to treatment with intravitreal bevacizumab (IVB).
Patients with newly diagnosed neovascular age-related macular degeneration and PED who were treated exclusively with IVB were included. Response to treatment was defined by change in PED volume (determined using spectral-domain optical coherence tomography). PEDs were classified as either predominantly serous or fibrovascular. Multivariable regression and receiver operating characteristic analyses were performed.
A total of 48 eyes were identified (mean follow-up time 73 weeks). Overall, the response to the first IVB treatment was predictive of the response to treatment at the final visit (P = 0.015). Serous PEDs had a greater decrease in volume at the final visit (P = 0.008). With respect to both PED types, a decrease in PED volume of 21% after the first IVB treatment was predictive of an overall decrease in volume of 30% at the final visit (sensitivity 83%, specificity 76%).
In neovascular age-related macular degeneration, serous PEDs respond more favorably to IVB than fibrovascular PEDs. Overall, for both types of PED, the response to the first treatment is predictive of the final response to treatment. Taken together, the results would suggest that if there is less than 21% reduction in PED volume after the first IVB treatment, and/or the PED is predominantly fibrovascular, then switching to another antivascular endothelial growth factor agent should be considered.
确定可预测新生血管性年龄相关性黄斑变性中色素上皮脱离（PED）对玻璃体内注射贝伐单抗（IVB）治疗反应的基线因素。
纳入仅接受IVB治疗的新诊断的新生血管性年龄相关性黄斑变性和PED患者。治疗反应通过PED体积变化（使用光谱域光学相干断层扫描确定）来定义。PED分为主要为浆液性或纤维血管性。进行多变量回归和受试者工作特征分析。
共纳入48只眼（平均随访时间73周）。总体而言，首次IVB治疗的反应可预测末次随访时的治疗反应（P = 0.015）。浆液性PED在末次随访时体积减少更大（P = 0.008）。对于两种类型的PED，首次IVB治疗后PED体积减少21%可预测末次随访时总体体积减少30%（敏感性83%，特异性76%）。
在新生血管性年龄相关性黄斑变性中，浆液性PED对IVB的反应比纤维血管性PED更有利。总体而言，对于两种类型的PED，首次治疗的反应可预测最终治疗反应。综合来看，结果表明，如果首次IVB治疗后PED体积减少小于21%，和/或PED主要为纤维血管性，则应考虑换用另一种抗血管内皮生长因子药物。
