Hwang Richard Y, Santos Daniella, Oliver Scott C N
Department of Ophthalmology, University of Colorado, Aurora, Colorado; and.
Department of Ophthalmology, Denver Health Medical Center, Denver, Colorado.
Retina. 2020 Apr;40(4):679-685. doi: 10.1097/IAE.0000000000002446.
To determine the recurrence rate of exudative age-related macular degeneration (wet AMD) in patients on 12-week dosing interval anti-vascular endothelial growth factor (anti-VEGF) bevacizumab therapy.
A retrospective chart review was performed on wet AMD patients treated with anti-VEGF therapy using a "treat-and-extend" methodology at one physician's practice site over 2 years (2012-2014). Charts were evaluated for visual acuity, anti-VEGF agent used, treatment interval, duration of treatment, trials off of anti-VEGF therapy, evidence of exudation, and wet AMD recurrence characteristics.
Three hundred and twenty-one wet AMD patients were treated. Fifty-seven eyes were without active exudation by clinical examination or optical coherence tomography (OCT) and were maintained on repeating 12-week interval suppressive anti-VEGF therapy. Sixteen percent (8/49) showed exudation recurrence with an average 10% cumulative recurrence rate per year for eyes on bevacizumab. Eight eyes without active exudation were discontinued off of bevacizumab therapy. Sixty-three percent (5/8) demonstrated recurrence on average 4 months after stopping therapy.
The findings in this study suggest that if a patient can be extended to 12-week interval bevacizumab therapy, there is on average a 10% chance of recurrence with each successive year. If anti-VEGF therapy is discontinued in these patients, there is an increased chance of recurrence by 4 months.
确定接受每12周给药一次抗血管内皮生长因子(抗VEGF)贝伐单抗治疗的渗出性年龄相关性黄斑变性(湿性年龄相关性黄斑变性,wet AMD)患者的复发率。
对在一位医生的执业地点采用“治疗并延长”方法接受抗VEGF治疗超过2年(2012 - 2014年)的湿性年龄相关性黄斑变性患者进行回顾性病历审查。评估病历中的视力、使用的抗VEGF药物、治疗间隔、治疗持续时间、停用抗VEGF治疗的情况、渗出证据以及湿性年龄相关性黄斑变性的复发特征。
共治疗了321例湿性年龄相关性黄斑变性患者。57只眼经临床检查或光学相干断层扫描(OCT)无活动性渗出,并维持每12周重复一次的抑制性抗VEGF治疗。16%(8/49)的患者出现渗出复发,接受贝伐单抗治疗的眼每年平均累积复发率为10%。8只无活动性渗出的眼停止了贝伐单抗治疗。63%(5/8)的患者在停药后平均4个月出现复发。
本研究结果表明,如果患者能够延长至每12周接受一次贝伐单抗治疗,那么每年平均有10%的复发几率。如果这些患者停用抗VEGF治疗,4个月后复发几率会增加。