Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, South Korea.
Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea.
Retina. 2018 Dec;38(12):2356-2362. doi: 10.1097/IAE.0000000000001876.
To compare 12-month treatment outcomes of Type 3 neovascularization among its different stages as classified using an optical coherence tomography-based method.
This retrospective observational study included 40 patients (40 eyes) who were newly diagnosed with Type 3 neovascularization. The patients were initially administered 3 monthly anti-vascular endothelial growth factor injections. Repeat treatment was performed when recurrence of fluid was noted. Disease staging was classified using the optical coherence tomography-based method. The best-corrected visual acuity at diagnosis and at 12 months and degree of change in best-corrected visual acuity were compared among the different stages of the disease. In addition, incidence of progression in the disease stages was estimated.
Among the 40 patients, 14 (35.0%) were classified as Stage 2 and 26 (65.0%) were classified as Stage 3. The best-corrected visual acuity values at diagnosis and at 12 months were 0.61 ± 0.31 (20/81 Snellen equivalents) and 0.46 ± 0.30 (20/57) in the Stage 2 group and 0.67 ± 0.42 (20/93) and 0.70 ± 0.49 (20/100) in the Stage 3 group, respectively. There was a significant difference in best-corrected visual acuity change between the two groups (P = 0.036). During the follow-up period, 3 retinal pigment epithelium tears and 2 submacular hemorrhages had developed in the Stage 3 group. Progression of the disease from Stage 2 to Stage 3 was noted in 2 patients (14.3%).
The visual outcome was worse in Stage 3 than in Stage 2, and adverse events that may lead to abrupt visual deterioration developed only in Stage 3. Further studies are needed to reveal whether anti-vascular endothelial growth factor therapy can suppress the progression of the disease stages.
比较基于光相干断层扫描（OCT）的分类方法，对不同分期的 3 型新生血管（NV）患者进行 12 个月的治疗结果。
本回顾性观察性研究纳入了 40 名（40 只眼）新诊断为 3 型 NV 的患者。患者最初接受 3 个月的抗血管内皮生长因子（VEGF）注射治疗。当发现液体再次出现时，进行重复治疗。使用基于 OCT 的方法对疾病进行分期。比较不同分期患者的诊断时和 12 个月时的最佳矫正视力（BCVA）以及 BCVA 的变化程度。此外，还估计了疾病分期的进展发生率。
在 40 名患者中，14 名（35.0%）患者被分类为 2 期，26 名（65.0%）患者被分类为 3 期。2 期组的诊断时和 12 个月时的 BCVA 值分别为 0.61±0.31（20/81 标准视力表）和 0.46±0.30（20/57），3 期组的 BCVA 值分别为 0.67±0.42（20/93）和 0.70±0.49（20/100）。两组间 BCVA 变化差异有统计学意义（P=0.036）。在随访期间，3 期组发生 3 例视网膜色素上皮撕裂和 2 例黄斑下出血。2 名患者（14.3%）疾病从 2 期进展到 3 期。
3 期的视力结果较 2 期差，只有在 3 期才会发生可能导致视力急剧恶化的不良事件。需要进一步的研究来揭示抗 VEGF 治疗是否能抑制疾病分期的进展。
