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视网膜前膜对新生血管性年龄相关性黄斑变性抗血管内皮生长因子治疗的影响。

Effect of Epiretinal Membranes on Antivascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration.

作者信息

Cho Han Joo, Kim Jae Min, Kim Hyoung Seok, Lee Dong Won, Kim Chul Gu, Kim Jong Woo

机构信息

Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine , Seoul, South Korea .

出版信息

J Ocul Pharmacol Ther. 2017 Jul/Aug;33(6):452-458. doi: 10.1089/jop.2016.0178. Epub 2017 Apr 26.

Abstract

PURPOSE

To evaluate the effect of epiretinal membranes (ERMs), detected with spectral-domain optical coherence tomography (SD-OCT), on the outcome of antivascular endothelial growth factor (VEGF) treatment for neovascular age-related macular degeneration (nAMD).

METHODS

A total of 434 eyes with treatment-naive nAMD were retrospectively included and analyzed. All patients were administered an initial series of 3 monthly loading injections of ranibizumab or aflibercept, followed by further injections as required. The visual and anatomical outcomes were compared between the eyes with ERMs and those without. Features of ERMs at baseline assessed with SD-OCT were evaluated and correlated with visual outcomes.

RESULTS

Sixty-eight eyes (15.7%) with nAMD presented ERMs at baseline. The mean best-corrected visual acuity (BCVA) of these eyes, expressed as the logarithm of the minimum angle of resolution, improved from 0.75 ± 0.48 (Snellen equivalent: 20/112) to 0.59 ± 0.44 (20/77) after 12 months of treatment (P = 0.021). Central foveal thickness also decreased from 381 ± 191 μm to 294 ± 167 μm (P < 0.001). Compared to the eyes without ERMs (366 eyes), the eyes with ERMs had a significantly thicker central fovea after treatment (P = 0.020). However, the intergroup differences in BCVA improvement were not significant. No significant association was found between visual outcome after treatment and ERM features on OCT at baseline.

CONCLUSIONS

In eyes with nAMD, ERMs were infrequent. Central foveal thickness was significantly greater after anti-VEGF treatment in eyes with nAMD and ERMs. However, the presence of ERMs in eyes with nAMD did not affect visual outcome.

摘要

目的

评估经光谱域光学相干断层扫描(SD-OCT)检测的视网膜前膜(ERM)对新生血管性年龄相关性黄斑变性(nAMD)抗血管内皮生长因子(VEGF)治疗效果的影响。

方法

回顾性纳入并分析434只初治nAMD患眼。所有患者均接受初始系列的3次每月一次的雷珠单抗或阿柏西普负荷注射,随后根据需要进一步注射。比较有ERM和无ERM患眼的视力和解剖学结果。评估用SD-OCT在基线时评估的ERM特征,并将其与视力结果相关联。

结果

68只(15.7%)nAMD患眼在基线时存在ERM。这些患眼的平均最佳矫正视力(BCVA),以最小分辨角的对数表示,在治疗12个月后从0.75±0.48(Snellen等效值:20/112)提高到0.59±0.44(20/77)(P = 0.021)。中心凹厚度也从381±191μm降至294±167μm(P < 0.001)。与无ERM的患眼(366只)相比,有ERM的患眼在治疗后中心凹明显更厚(P = 0.020)。然而,两组间BCVA改善的差异不显著。在治疗后的视力结果与基线时OCT上的ERM特征之间未发现显著关联。

结论

在nAMD患眼中,ERM并不常见。nAMD合并ERM的患眼在抗VEGF治疗后中心凹厚度明显更大。然而,nAMD患眼中ERM的存在并不影响视力结果。

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