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抗血管内皮生长因子疗法治疗近视性脉络膜新生血管

Anti-Vascular Endothelial Growth Factor Therapy for Myopic Choroidal Neovascularization.

作者信息

Ng Danny S C, Lai Timothy Y Y, Cheung Chui Ming Gemmy, Ohno-Matsui Kyoko

机构信息

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.

2010 Retina and Macula Centre, Hong Kong.

出版信息

Asia Pac J Ophthalmol (Phila). 2017 Nov-Dec;6(6):554-560. doi: 10.22608/APO.2017308. Epub 2017 Oct 20.

Abstract

Myopic choroidal neovascularization (CNV) is one of the most vision-impairing complications in patients with pathologic myopia. It is also one of the most frequently encountered non.age-related macular degeneration causes of CNV and affects young patients in the working age group. Fluorescein angiography (FA) and spectral domain optical coherence tomography (OCT) are generally indicated to confirm the diagnosis of active myopic CNV before initiation of treatment. Without treatment, natural history studies have shown that the vision outcome can be very poor. More recently, a number of retrospective, prospective and phase 3, multicenter, randomized controlled trials have established the safety and efficacy of intravitreal anti.vascular endothelial growth factor (VEGF) agents for the treatment of myopic CNV. Long-term follow-up studies have found that some of the initial vision gained after intravitreal anti-VEGF therapy may not be maintained, owing to the presence and progression of chorioretinal atrophy (CRA) adjacent to the CNV. Further research on clinical and imaging characteristics may elucidate the prognostic factors that are crucial to optimizing the treatment and prevention of visual impairment associated with myopic CNV.

摘要

近视性脉络膜新生血管(CNV)是病理性近视患者中最损害视力的并发症之一。它也是最常见的非年龄相关性黄斑变性导致的CNV病因之一,且影响工作年龄组的年轻患者。荧光素血管造影(FA)和光谱域光学相干断层扫描(OCT)通常用于在开始治疗前确诊活动性近视性CNV。未经治疗的自然史研究表明,视力预后可能非常差。最近,一些回顾性、前瞻性以及3期多中心随机对照试验证实了玻璃体内注射抗血管内皮生长因子(VEGF)药物治疗近视性CNV的安全性和有效性。长期随访研究发现,由于CNV附近存在脉络膜视网膜萎缩(CRA)并进展,玻璃体内抗VEGF治疗后最初获得的部分视力可能无法维持。对临床和影像学特征的进一步研究可能会阐明对优化近视性CNV相关视力损害的治疗和预防至关重要的预后因素。

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