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根据 3 型新生血管(视网膜血管性息肉样增生)的光相干断层扫描分期的治疗结果差异。

DIFFERENCE IN TREATMENT OUTCOMES ACCORDING TO OPTICAL COHERENCE TOMOGRAPHY-BASED STAGES IN TYPE 3 NEOVASCULARIZATION (RETINAL ANGIOMATOUS PROLIFERATION).

机构信息

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.

出版信息

Retina. 2018 Dec;38(12):2356-2362. doi: 10.1097/IAE.0000000000001876.

Abstract

PURPOSE

To compare 12-month treatment outcomes of Type 3 neovascularization among its different stages as classified using an optical coherence tomography-based method.

METHODS

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.

RESULTS

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%).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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