Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, B.C.
The BC Provincial Retinal Diseases Treatment Program, Provincial Health Services Authority, Vancouver, B.C.
Can J Ophthalmol. 2018 Dec;53(6):627-631. doi: 10.1016/j.jcjo.2018.01.013. Epub 2018 Feb 21.
To assess effectiveness of intravitreous bevacizumab in a cohort of patients with neovascular age-related macular degeneration (nAMD) in British Columbia, Canada.
Retrospective cohort study.
Patients with new-onset AMD who completed 1 year of bevacizumab treatment.
A cohort of 4507 patients with nAMD (5174 eyes) aged 50 years and older treated on an as-needed basis with bevacizumab was followed from June 1, 2010, to May 31, 2014, and then evaluated after completing a follow-up treatment at 1 year. Descriptive statistics were used to characterize eyes treated with bevacizumab. Multivariable regression models were used to quantify visual acuity (VA) changes over time, adjusting for baseline prognostic variables.
On average, patients received 8.6 injections (SD 2.4) per eye during the year of treatment. There was an average gain of 5.2 letters over the 1-year study period. Among eyes treated with bevacizumab, improvement in VA was greater for eyes with poorer baseline VA and for eyes receiving more injections. The odds ratio for VA at 1 year was 9.35 (95% CI 6.00-14.6) for eyes with VA 20/50-20/80 versus 20/20-20/40 and increased to 74.5 (95% CI 47.7-116.4) for eyes 20/400 or worse versus 20/20-20/40.
Intravitreous bevacizumab is effective in treating nAMD, especially for eyes with poor baseline VA. Gains in VA were greatest by month 3 and were generally maintained thereafter.
评估玻璃体内贝伐单抗治疗不列颠哥伦比亚省新发性年龄相关性黄斑变性（nAMD）患者的疗效。
回顾性队列研究。
接受贝伐单抗治疗 1 年的新发性 AMD 患者。
对 2010 年 6 月 1 日至 2014 年 5 月 31 日接受按需治疗的新发性 nAMD 患者（5174 只眼）进行了一项贝伐单抗治疗队列研究，4507 例年龄 50 岁及以上患者在 1 年的随访期内完成了治疗，并在完成 1 年的后续治疗后进行了评估。描述性统计用于描述接受贝伐单抗治疗的眼睛。多变量回归模型用于量化随时间变化的视力（VA）变化，调整基线预后变量。
平均而言，患者每只眼在治疗的 1 年内接受了 8.6 次注射（SD 2.4）。在 1 年的研究期间，平均提高了 5.2 个字母。在接受贝伐单抗治疗的眼睛中，VA 改善更大的是基线 VA 较差的眼睛和接受更多注射的眼睛。VA 1 年时的比值比（OR）为 9.35（95%可信区间[CI]为 6.00-14.6），VA 为 20/50-20/80 的眼睛与 VA 为 20/20-20/40 的眼睛相比，而 VA 为 20/400 或更差的眼睛的 OR 增加到 74.5（95% CI 为 47.7-116.4），VA 为 20/20-20/40。
玻璃体内贝伐单抗治疗 nAMD 是有效的，特别是对基线 VA 较差的眼睛。VA 的提高在第 3 个月最大，并在此后基本保持。
