Rahimy Ehsan, Rayess Nadim, Ho Allen C, Regillo Carl D
Mid Atlantic Retina, The Retina Service of Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
Retina. 2016 May;36(5):875-80. doi: 10.1097/IAE.0000000000000814.
To determine treatment outcomes in eyes with neovascular age-related macular degeneration having visual acuity better than 20/40 after 1 years to 2 years of ranibizumab or bevacizumab therapy using a treat-and-extend regimen.
Retrospective observational case series. Clinical records were reviewed from patients with treatment-naive neovascular age-related macular degeneration and baseline best-corrected Snellen visual acuity >20/40 treated with intravitreal ranibizumab or bevacizumab for a minimum of 1 year using a treat-and-extend regimen. The primary outcome measures were change from initial visual acuity, proportion of eyes losing <3 best-corrected visual acuity lines, proportion of eyes maintaining visual acuity ≥20/40, change from baseline central retinal thickness, and mean number of injections after 1 years and 2 years of follow-up.
A total of 42 eyes from 40 patients were included. The mean follow-up period was 1.44 years. The mean initial logMAR visual acuity was 0.226, and remained stable at 0.257 and 0.267 after 1 years and 2 years of follow-up, respectively. At baseline, mean central retinal thickness was 305.8 μm, improved to 272.6 μm after 1 year of treatment (P < 0.001), and remained stable at 266.2 μm (P = 0.015) after 2 years. At 1-year follow-up period, 94.4% of eyes had lost less than 3 Snellen lines, and 94.1% of eyes lost less than 3 Snellen lines after 2 years. The percentage of eyes maintaining visual acuity ≥20/40 was 81% and 75% after each year. Eyes received on average 7.8 injections during the first year of treatment and 6.1 injections over the second year.
Eyes with neovascular age-related macular degeneration presenting with initial visual acuity better than 20/40 on average maintained vision, lost less than 3 lines of acuity, and achieved anatomical improvements using a treat-and-extend regimen over a 2-year period.
使用按需治疗并延长治疗间隔的方案，确定接受雷珠单抗或贝伐单抗治疗1至2年的新生血管性年龄相关性黄斑变性患者，初始视力优于20/40的患眼的治疗效果。
回顾性观察病例系列。对未经治疗的新生血管性年龄相关性黄斑变性且基线最佳矫正视力>20/40的患者的临床记录进行回顾，这些患者接受玻璃体内注射雷珠单抗或贝伐单抗治疗至少1年，采用按需治疗并延长治疗间隔的方案。主要观察指标为初始视力的变化、最佳矫正视力下降<3行的患眼比例、视力维持在≥20/40的患眼比例、视网膜中央厚度相对于基线的变化，以及随访1年和2年后的平均注射次数。
共纳入40例患者的42只眼。平均随访期为1.44年。初始平均logMAR视力为0.226，随访1年和2年后分别稳定在0.257和0.267。基线时，视网膜中央平均厚度为305.8μm，治疗1年后改善至272.6μm（P<0.001），2年后稳定在266.2μm（P=0.015）。在1年随访期时，94.4%的患眼视力下降少于3行，2年后94.1%的患眼视力下降少于3行。每年视力维持在≥20/40的患眼比例分别为81%和75%。治疗第一年患眼平均接受7.8次注射，第二年平均接受6.1次注射。
初始视力优于20/40的新生血管性年龄相关性黄斑变性患眼，平均而言，在2年期间采用按需治疗并延长治疗间隔的方案可维持视力，视力下降少于3行，并实现解剖学改善。
