Hospices Civils de Lyon, Groupement Hospitalier Nord, Hôpital de la Croix-Rousse, Service d'ophtalmologie, Lyon, France.
Université de Lyon, Lyon, France.
Retina. 2018 Aug;38(8):1492-1499. doi: 10.1097/IAE.0000000000001736.
To determine predictors of best-corrected visual acuity (BCVA) outcomes 1 year after ranibizumab or bevacizumab treatment for neovascular age-related macular degeneration, within the French Study Group Avastin versus Lucentis for neovascular age-related macular degeneration (GEFAL).
Patients aged ≥50 years presenting subfoveal neovascular age-related macular degeneration were randomized to receive ranibizumab or bevacizumab (3 monthly intravitreal injections followed by an as-needed regimen). The main outcome measures were BCVA and its change from baseline at 1 year. Variables with a P value <0.20 in the univariate model and/or which were clinically relevant were included in the multivariate analysis.
The following baseline factors were associated with a lower BCVA score at 1 year and with less improvement in BCVA (multivariate analysis): intraretinal fluid, thickness of central subfield macular ≤277 μm, predominantly classic choroidal neovascularization, and total area of choroidal neovascularization (all P ≤ 0.01). Pigment epithelium detachment and high baseline BCVA were associated with less improvement in BCVA (P = 0.03, P = 0.05, respectively). Patients who met retreatment criteria but did not receive the corresponding injection had significantly poorer outcomes (only tested in the univariate analysis).
This study confirms the predictors of BCVA score at 1 year posttreatment; the presence of intraretinal fluid was associated with a poor prognosis.
在法国研究小组 Avastin 与 Lucentis 治疗新生血管性年龄相关性黄斑变性(GEFAL)中,确定雷珠单抗或贝伐单抗治疗新生血管性年龄相关性黄斑变性 1 年后最佳矫正视力(BCVA)结局的预测因素。
年龄≥50 岁、出现黄斑下新生血管性年龄相关性黄斑变性的患者被随机分配接受雷珠单抗或贝伐单抗治疗(3 个月玻璃体内注射,随后按需治疗)。主要观察指标为 1 年时的 BCVA 及其与基线的变化。单变量模型中 P 值<0.20 的变量和/或有临床意义的变量被纳入多变量分析。
以下基线因素与 1 年后 BCVA 评分较低和 BCVA 改善较少相关(多变量分析):视网膜内液、中央凹下黄斑中心厚度≤277μm、主要为经典脉络膜新生血管和脉络膜新生血管总面积(均 P≤0.01)。色素上皮脱离和较高的基线 BCVA 与 BCVA 改善较少相关(P=0.03,P=0.05)。符合再治疗标准但未接受相应注射的患者结局明显较差(仅在单变量分析中进行了测试)。
本研究证实了治疗后 1 年 BCVA 评分的预测因素;视网膜内液的存在与预后不良相关。