Hwang Hyun Ji, Kim Jae Hui, Chang Young Suk, Kim Jong Woo, Kim Chul Gu
Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.
Korean J Ophthalmol. 2017 Jun;31(3):230-239. doi: 10.3341/kjo.2016.0035. Epub 2017 May 12.
To evaluate the long-term outcomes of anti-vascular endothelial growth factor (VEGF) therapy for polypoidal choroidal vasculopathy (PCV) with feeder vessels and to investigate fellow-eye findings.
This retrospective observational study included 14 eyes with treatment-naïve PCV accompanied by feeder vessels that were treated with anti-VEGF monotherapy. The best-corrected visual acuity (BCVA) at baseline was compared with that at the last follow-up. The fellow-eye indocyanine green angiography findings were also analyzed.
The mean follow-up period was 28.1 ± 19.2 months (range, 12 to 60 months). During the follow-up period, 5.9 ± 2.5 anti-VEGF injections were administered. The logarithm of the minimal angle of resolution (logMAR) BCVAs at the time of diagnosis, at 3 months, and at the last follow-up were 0.81 ± 0.49, 0.55 ± 0.44, and 0.71 ± 0.54, respectively. Although the BCVA at the last follow-up was not different from the baseline value (p=0.809), an improvement of ≥0.2 logMAR BCVA was observed in seven eyes (50.0%). In 11 eyes that underwent bilateral indocyanine green angiography at diagnosis, PCV, branching vascular networks, and late geographic hyperfluorescence were noted in two (18.2%), five (45.4%), and three (27.3%) fellow eyes, respectively. During the follow-up period, the development of polypoidal lesions in the fellow eye was observed in three patients.
In this study, long-term improvement in BCVA was noted in 50% of the included patients who received anti-VEGF monotherapy. A relatively high incidence of pathological findings in the fellow eye and bilateral involvement suggest the need for bilateral examinations.
评估抗血管内皮生长因子（VEGF）疗法治疗伴有滋养血管的息肉样脉络膜血管病变（PCV）的长期疗效，并研究对侧眼的情况。
这项回顾性观察研究纳入了14只初治的伴有滋养血管的PCV眼，采用抗VEGF单药治疗。将基线时的最佳矫正视力（BCVA）与最后一次随访时的进行比较。同时分析对侧眼的吲哚青绿血管造影结果。
平均随访期为28.1±19.2个月（范围12至60个月）。随访期间，平均进行了5.9±2.5次抗VEGF注射。诊断时、3个月时和最后一次随访时的最小分辨角对数（logMAR）BCVA分别为0.81±0.49、0.55±0.44和0.71±0.54。尽管最后一次随访时的BCVA与基线值无差异（p = 0.809），但7只眼（50.0%）的BCVA改善≥0.2 logMAR。在诊断时接受双侧吲哚青绿血管造影的11只眼中，分别在2只（18.2%）、5只（45.4%）和3只（27.3%）对侧眼中发现了PCV、分支血管网和晚期地图样高荧光。随访期间，3例患者的对侧眼出现了息肉样病变。
在本研究中，接受抗VEGF单药治疗的患者中有50%的BCVA得到了长期改善。对侧眼病理表现的发生率相对较高且存在双侧受累情况，提示需要进行双侧检查。
