Battaglia Parodi Maurizio, Romano Francesco, Marchese Alessandro, Arrigo Alessandro, Llorenç Victor, Cicinelli Maria Vittoria, Bandello Francesco, Adán Alfredo
Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute, via Olgettina, 60, 20132, Milan, Italy.
Institut Clínic d'Oftalmologia, Hospital Clínic de Barcelona, Barcelona, Spain.
Graefes Arch Clin Exp Ophthalmol. 2019 Feb;257(2):273-278. doi: 10.1007/s00417-018-4190-7. Epub 2018 Nov 23.
To evaluate the efficacy of intravitreal anti-VEGF injections in choroidal neovascularization (CNV) related to pattern dystrophy-like deposit in pseudoxanthoma elasticum (PXE).
One-year prospective, interventional study. Nine eyes were recruited in the ophthalmology departments of San Raffaele University and University of Barcelona. Each patient underwent best corrected visual acuity (BCVA) measurement on ETDRS chart, slit-lamp biomicroscopy, fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). The protocol included a first anti-VEGF injection, followed by monthly evaluations with re-treatments based on new funduscopic hemorrhages, fluid on OCT or leakage on FA and/or ICGA. Primary outcome measures were the mean BCVA changes. Secondary outcomes included central macular thickness (CMT) variations and the number of injections needed.
At month 12, mean BCVA significantly improved from 20/45 to 20/35 Snellen equivalent, with 3 eyes gaining at least 3 ETDRS lines. Mean CMT decreased from 297 ± 22 to 262 ± 13 μm, after 5.5 ± 4.0 injections. No leakage was observed at the end of follow-up.
Intravitreal anti-VEGF injections represent an effective treatment for CNV related to pattern dystrophy-like deposit in PXE, with an improvement of BCVA and CMT. Mean injection number is in line with other studies performed in CNV secondary to angioid streaks.
评估玻璃体内注射抗血管内皮生长因子（VEGF）治疗弹性假黄瘤（PXE）中与图案样营养不良样沉积物相关的脉络膜新生血管（CNV）的疗效。
为期一年的前瞻性干预研究。招募了圣拉斐尔大学和巴塞罗那大学眼科的9只眼睛。每位患者均接受了ETDRS视力表最佳矫正视力（BCVA）测量、裂隙灯生物显微镜检查、荧光素血管造影（FA）、吲哚菁绿血管造影（ICGA）和光学相干断层扫描（OCT）。方案包括首次抗VEGF注射，随后每月进行评估，并根据新出现的眼底出血、OCT上的液体积聚或FA和/或ICGA上的渗漏情况进行再次治疗。主要观察指标为BCVA的平均变化。次要观察指标包括中心黄斑厚度（CMT）变化和所需注射次数。
在第12个月时，平均BCVA从20/45 Snellen等效视力显著提高到20/35，3只眼睛至少提高了3条ETDRS视力线。在平均5.5±4.0次注射后，平均CMT从297±22μm降至262±13μm。随访结束时未观察到渗漏。
玻璃体内注射抗VEGF是治疗PXE中与图案样营养不良样沉积物相关的CNV的有效方法，可改善BCVA和CMT。平均注射次数与在继发于血管样条纹的CNV中进行的其他研究一致。
