Vaz-Pereira Sara, Marques Inês P, Matias João, Mira Filipe, Ribeiro Lígia, Flores Rita
1 Department of Ophthalmology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon - Portugal.
2 Department of Ophthalmology, Faculty of Medicine, Universidade de Lisboa, Lisbon - Portugal.
Eur J Ophthalmol. 2017 Nov 8;27(6):756-761. doi: 10.5301/ejo.5000943.
Retinal vein occlusion (RVO) is an important cause of visual disability in the modern world. We aim to evaluate the real-world outcomes of patients with RVO treated with anti-vascular endothelial growth factor (VEGF) in Portugal.
We performed a retrospective, observational, multicenter study including 8 centers across Portugal and 200 patients treated with either ranibizumab or bevacizumab. Data were collected at 3 time points: time of diagnosis (0 time point) and 6 and 12 months after initiating treatment. Demographic and clinical data were collected.
Median visual acuity (VA) and central macular thickness (CMT) improved in the branch RVO (BRVO), central RVO (CRVO), bevacizumab, and ranibizumab groups at 6 and 12 months compared to baseline, with CMT improving further only in the CRVO and ranibizumab groups between 6 and 12 months (p = 0.002 and p = 0.001, respectively). The CMT was lower in the ranibizumab group compared to the bevacizumab group both at 6 and 12 months (p<0.02). Median CMT improved in both the good and poor baseline VA groups at 6 and 12 months compared to baseline (p<0.001). Median VA only improved for the group with poor baseline VA at 6 and 12 months of follow-up (p<0.001). Regression analysis identified several baseline variables as predictors of visual outcomes at 6 and 12 months, with different results depending on the analyzed group.
Both treatments were effective, although less effective than results reported in clinical trials. The morphologic response was better with ranibizumab compared to bevacizumab, although functionally there were no differences.
视网膜静脉阻塞（RVO）是现代社会导致视力残疾的一个重要原因。我们旨在评估在葡萄牙接受抗血管内皮生长因子（VEGF）治疗的RVO患者的实际治疗效果。
我们开展了一项回顾性、观察性、多中心研究，纳入了葡萄牙全国8个中心的200例接受雷珠单抗或贝伐单抗治疗的患者。在3个时间点收集数据：诊断时（0时间点）以及开始治疗后的6个月和12个月。收集了人口统计学和临床数据。
与基线相比，分支视网膜静脉阻塞（BRVO）、中央视网膜静脉阻塞（CRVO）、贝伐单抗和雷珠单抗组在6个月和12个月时的中位视力（VA）和中心黄斑厚度（CMT）均有所改善，仅CRVO组和雷珠单抗组在6至12个月期间CMT进一步改善（分别为p = 0.002和p = 0.001）。在6个月和12个月时，雷珠单抗组的CMT均低于贝伐单抗组（p<0.02）。与基线相比，6个月和12个月时，基线视力良好和较差的两组患者的CMT均有所改善（p<0.001）。仅在随访6个月和12个月时，基线视力较差的组中位视力有所改善（p<0.001）。回归分析确定了几个基线变量作为6个月和12个月时视力结果的预测因素，根据分析的组不同结果也不同。
两种治疗方法均有效，尽管不如临床试验报告的结果有效。与贝伐单抗相比，雷珠单抗的形态学反应更好，尽管在功能上没有差异。
