Hata Masayuki, Yamashiro Kenji, Oishi Akio, Ooto Sotaro, Tamura Hiroshi, Miyata Manabu, Ueda-Arakawa Naoko, Kuroda Yoshimasa, Takahashi Ayako, Tsujikawa Akitaka, Yoshimura Nagahisa
*Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; and †Department of Ophthalmology, Faculty of Medicine, Kagawa University, Miki, Japan.
Retina. 2017 Nov;37(11):2069-2077. doi: 10.1097/IAE.0000000000001457.
To investigate the incidence rate and risk factors for development of retinal pigment epithelial (RPE) atrophy during anti-vascular endothelial growth factor (anti-VEGF) treatment for retinal angiomatous proliferation.
This study included 46 eyes with treatment-naive retinal angiomatous proliferation. All patients were treated with ranibizumab or aflibercept injections. Color fundus photography, spectral-domain optical coherence tomography, and fundus autofluorescence were evaluated for RPE atrophy diagnosis. Baseline characteristics and gene polymorphisms of ARMS2 A69S, and CFH I62V were analyzed for association with development and progression of RPE atrophy.
Among 21 eyes treated with ranibizumab without preexisting RPE atrophy at baseline, 5 eyes (23.8%) developed RPE atrophy at 12 months. Among 20 eyes treated with aflibercept without preexisting RPE atrophy at baseline, 10 eyes (50.0%) developed RPE atrophy at 12 months. Refractile drusen at baseline was associated with RPE atrophy development at 12 months (P = 0.014), and the progression rate of RPE atrophy area was negatively correlated with subfoveal choroidal thickness at baseline (R = -0.595, P = 0.019). Gene polymorphisms were not associated with RPE atrophy.
Retinal pigment epithelial atrophy developed in 36.6% during 12 months after anti-VEGF treatment for retinal angiomatous proliferation. The presence of refractile drusen at baseline was identified as a novel significant risk factor for RPE atrophy development.
探讨抗血管内皮生长因子（抗VEGF）治疗视网膜血管瘤样增殖期间视网膜色素上皮（RPE）萎缩的发生率及危险因素。
本研究纳入46例初治视网膜血管瘤样增殖患者的眼。所有患者均接受雷珠单抗或阿柏西普注射治疗。采用彩色眼底照相、光谱域光学相干断层扫描和眼底自发荧光评估RPE萎缩诊断情况。分析ARMS2 A69S和CFH I62V的基线特征及基因多态性与RPE萎缩发生和进展的相关性。
在21例基线时无RPE萎缩且接受雷珠单抗治疗的眼中，5眼（23.8%）在12个月时出现RPE萎缩。在20例基线时无RPE萎缩且接受阿柏西普治疗的眼中，10眼（50.0%）在12个月时出现RPE萎缩。基线时的硬性玻璃膜疣与12个月时RPE萎缩的发生相关（P = 0.014），RPE萎缩面积的进展率与基线时黄斑中心凹下脉络膜厚度呈负相关（R = -0.595，P = 0.019）。基因多态性与RPE萎缩无关。
抗VEGF治疗视网膜血管瘤样增殖后12个月内，36.6%的患者发生视网膜色素上皮萎缩。基线时存在硬性玻璃膜疣被确定为RPE萎缩发生的一个新的重要危险因素。
