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新生血管性年龄相关性黄斑变性1型病变的脉络膜厚度与视觉预后

Choroidal thickness and visual prognosis in type 1 lesion due to neovascular age-related macular degeneration.

作者信息

Hernández-Martínez Pablo, Dolz-Marco Rosa, Hervás-Marín David, Andreu-Fenoll Maria, Gallego-Pinazo Roberto, Arévalo José Fernando

机构信息

Unit of Macula, Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia - Spain.

RETICS Oftared, Instituto de Salud Carlos III, Madrid - Spain.

出版信息

Eur J Ophthalmol. 2017 Mar 10;27(2):196-200. doi: 10.5301/ejo.5000860. Epub 2016 Sep 17.

Abstract

PURPOSE

To evaluate the association between subfoveal choroidal thickness and the visual outcome in eyes with type 1 choroidal neovascularization (CNV) due to neovascular age-related macular degeneration (nAMD).

METHODS

This was a retrospective, longitudinal, cross-sectional study including patients diagnosed with nAMD type 1 lesions managed with intravitreal injections of ranibizumab in a PRN strategy during 24 months. Retrospective chart review of patients with type 1 CNV recording the visual acuity, number of intravitreal injections, multimodal imaging data, and follow-up period was performed. Subfoveal choroidal thickness was measured using enhanced depth imaging scans obtained with spectral-domain optical coherence tomography.

RESULTS

Twenty-five eyes of 21 patients were included. The mean baseline logMAR best-corrected visual acuity was 0.52 (+0.35) (median 0.5; range 0.1-1; interquartile range (IQR) 0.3-0.8) and improved to 0.39 (+0.39) (median 0.4; range 0.1-1; IQR 0.2-0.5) by the end of the follow-up (p = 0.038). Subfoveal choroidal thickness was 202.8 (+60.3) μm (median 218; range 81-285; IQR 146-258). Statistical mixed effects model demonstrated an association between rate of improvement of visual acuity with subfoveal choroidal thickness after 24 months (p<0.001) (95% confidence interval 0.0002-0.0001 logMAR month μm); higher thickness values were correlated with better visual acuity.

CONCLUSIONS

Thicker subfoveal choroid was associated with better visual outcomes in patients with type 1 CNV due to nAMD following a strict PRN regimen with intravitreal ranibizumab at 24 months of follow-up.

摘要

目的

评估因新生血管性年龄相关性黄斑变性(nAMD)导致的1型脉络膜新生血管(CNV)患者的黄斑中心凹下脉络膜厚度与视力预后之间的关联。

方法

这是一项回顾性、纵向、横断面研究,纳入了在24个月内采用按需给药策略玻璃体内注射雷珠单抗治疗的1型nAMD病变患者。对1型CNV患者进行回顾性病历审查,记录视力、玻璃体内注射次数、多模态成像数据和随访时间。使用光谱域光学相干断层扫描获得的增强深度成像扫描测量黄斑中心凹下脉络膜厚度。

结果

纳入了21例患者的25只眼。平均基线logMAR最佳矫正视力为0.52(+0.35)(中位数0.5;范围0.1 - 1;四分位间距(IQR)0.3 - 0.8),随访结束时提高到0.39(+0.39)(中位数0.4;范围0.1 - 1;IQR 0.2 - 0.5)(p = 0.038)。黄斑中心凹下脉络膜厚度为202.8(+60.3)μm(中位数218;范围81 - 285;IQR 146 - 258)。统计混合效应模型显示,24个月后视力改善率与黄斑中心凹下脉络膜厚度之间存在关联(p<0.001)(95%置信区间0.0002 - 0.0001 logMAR/月/μm);厚度值越高,视力越好。

结论

在严格按需给药方案下,随访24个月时,因nAMD导致的1型CNV患者中,较厚的黄斑中心凹下脉络膜与较好的视力预后相关。

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