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脉络膜厚度作为阿柏西普或雷珠单抗光动力疗法治疗息肉状脉络膜血管病变的预后因素

CHOROIDAL THICKNESS AS A PROGNOSTIC FACTOR OF PHOTODYNAMIC THERAPY WITH AFLIBERCEPT OR RANIBIZUMAB FOR POLYPOIDAL CHOROIDAL VASCULOPATHY.

作者信息

Sakurada Yoichi, Sugiyama Atsushi, Tanabe Naohiko, Kikushima Wataru, Kume Atsuki, Iijima Hiroyuki

机构信息

Departments of Ophthalmology, Faculty of Medicine, University of Yamanashi.

出版信息

Retina. 2017 Oct;37(10):1866-1872. doi: 10.1097/IAE.0000000000001427.

Abstract

PURPOSE

To investigate factors associated with visual improvement and retreatment 12 months after a combination therapy of intravitreal injection of ranibizumab or aflibercept followed by photodynamic therapy for polypoidal choroidal vasculopathy.

METHODS

Changes in the best-corrected visual acuity and the subfoveal thickness of the retina and choroid were studied in 56 consecutive eyes with polypoidal choroidal vasculopathy treated initially with a combination therapy of either intravitreal ranibizumab injection (n = 23) or intravitreal aflibercept injection (n = 33) followed by photodynamic therapy. Factors associated with visual improvement and retreatment were investigated.

RESULTS

Best-corrected visual acuity significantly improved with significant reduction in central macular thickness and subfoveal choroidal thickness at all points irrespective of treatment modalities (P < 0.001). Better best-corrected visual acuity and improvement of best-corrected visual acuity at 12 months were associated with baseline greater subfoveal choroidal thickness (P = 0.028 and P = 0.028) and baseline smaller greatest linear dimension (P = 0.0077 and P = 0.0077). Retreatment during 12-month follow-up was associated with baseline lesser subfoveal choroidal thickness (P = 0.036).

CONCLUSION

Irrespective of treatment modalities, the visual outcome at 12 months is favorable in eyes with polypoidal choroidal vasculopathy treated by photodynamic therapy combined with intravitreal ranibizumab or aflibercept. Baseline greater subfoveal choroidal thickness was associated with a better visual outcome and with reduction in the need for retreatment.

摘要

目的

研究玻璃体内注射雷珠单抗或阿柏西普联合光动力疗法治疗息肉状脉络膜血管病变12个月后与视力改善及再次治疗相关的因素。

方法

对56例初诊采用玻璃体内注射雷珠单抗(n = 23)或玻璃体内注射阿柏西普(n = 33)联合光动力疗法治疗的息肉状脉络膜血管病变患者的连续眼进行研究,观察最佳矫正视力、视网膜及脉络膜黄斑中心凹下厚度的变化,调查与视力改善及再次治疗相关的因素。

结果

无论治疗方式如何,所有时间点的最佳矫正视力均显著提高,黄斑中心厚度及黄斑中心凹下脉络膜厚度均显著降低(P < 0.001)。12个月时更好的最佳矫正视力及最佳矫正视力的改善与基线时更大的黄斑中心凹下脉络膜厚度相关(P = 0.028及P = 0.028),与基线时更小的最大线性尺寸相关(P = 0.0077及P = 0.0077)。12个月随访期间的再次治疗与基线时较小的黄斑中心凹下脉络膜厚度相关(P = 0.036)。

结论

无论治疗方式如何,光动力疗法联合玻璃体内注射雷珠单抗或阿柏西普治疗的息肉状脉络膜血管病变患者在12个月时视力预后良好。基线时更大的黄斑中心凹下脉络膜厚度与更好的视力预后及再次治疗需求的减少相关。

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