Ogasawara Masashi, Koizumi Hideki, Yamamoto Akiko, Itagaki Kanako, Saito Masaaki, Maruko Ichiro, Okada Annabelle A, Iida Tomohiro, Sekiryu Tetsuju
Department of Ophthalmology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.
Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan.
Jpn J Ophthalmol. 2018 Sep;62(5):584-591. doi: 10.1007/s10384-018-0605-6. Epub 2018 Jul 4.
To determine factors predictive of visual outcomes in eyes treated with intravitreal aflibercept injections (IAIs) for typical neovascular age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV).
Retrospective, multicenter, institutional, consecutive, interventional case series.
One hundred nine eyes (107 patients) with treatment-naïve neovascular AMD at 3 university hospitals were studied. After a loading phase of 3 monthly 2.0-mg IAIs, injections were administered every 2 months. The baseline clinical characteristics were investigated in relation to the 12-month visual outcomes. Changes in the mean best-corrected visual acuity (BCVA) were measured at 12 months after initiation of aflibercept therapy.
Forty-five eyes (41.3%) had typical neovascular AMD, and 64 eyes (58.7%) had PCV. The changes in the mean BCVA at 12 months compared with baseline did not differ significantly (P = .737) between the 2 groups. Stepwise analysis showed that larger gains in the BCVA at 12 months were associated with poor BCVA (P < .001), no pigment epithelial detachment (P = .004), and subretinal fluid (P = .039) at baseline in eyes with typical neovascular AMD; larger gains in the BCVA were associated with poorer BCVA (P < .001), presence of choroidal vascular hyperpermeability (CVH) (P = .013), and subretinal fluid (P = .044) at baseline in eyes with PCV.
Although poorer BCVA and the presence of subretinal fluid predicted larger gains in BCVA in both subtypes treated with aflibercept, eyes with typical neovascular AMD had greater improvement if no pigment epithelial detachment was present, while eyes with PCV had greater improvement if CVH was present.
确定接受玻璃体内注射阿柏西普（IAIs）治疗的典型新生血管性年龄相关性黄斑变性（AMD）或息肉样脉络膜血管病变（PCV）患者视力预后的预测因素。
回顾性、多中心、机构性、连续性、干预性病例系列研究。
对3家大学医院的109只眼（107例患者）初治新生血管性AMD进行研究。在3个月每月注射2.0mg阿柏西普的负荷期后，每2个月注射一次。研究基线临床特征与12个月视力预后的关系。在阿柏西普治疗开始12个月时测量平均最佳矫正视力（BCVA）的变化。
45只眼（41.3%）为典型新生血管性AMD，64只眼（58.7%）为PCV。两组在12个月时平均BCVA较基线的变化无显著差异（P = 0.737）。逐步分析显示，典型新生血管性AMD患者在12个月时BCVA提高幅度较大与基线时BCVA较差（P < 0.001）、无色素上皮脱离（P = 0.004）和视网膜下液（P = 0.039）有关；PCV患者在12个月时BCVA提高幅度较大与基线时BCVA较差（P < 0.001）、存在脉络膜血管高通透性（CVH）（P = 0.013）和视网膜下液（P = 0.044）有关。
尽管在接受阿柏西普治疗的两种亚型中，较差的BCVA和视网膜下液的存在预示着BCVA有更大的提高，但典型新生血管性AMD患者如果不存在色素上皮脱离，则改善更大，而PCV患者如果存在CVH，则改善更大。
