Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea.
J Ocul Pharmacol Ther. 2019 Apr;35(3):174-181. doi: 10.1089/jop.2018.0107. Epub 2019 Feb 26.
To compare the effectiveness of intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment for pachychoroid neovasculopathy and neovascular age-related macular degeneration (AMD).
Twenty-two eyes with pachychoroid neovasculopathy and 183 eyes with neovascular AMD were retrospectively included for analysis. All patients were treatment naive and received an initial series of 3 monthly loading injections of anti-VEGF, followed by further injections as required. The visual and anatomical outcomes after treatment were evaluated at 12 months from baseline.
The pachychoroid neovasculopathy group showed a significant improvement in the mean best-corrected visual acuity (BCVA; logarithm of the minimum angle of resolution) from 0.50 ± 0.32 (Snellen equivalent; 20/63) to 0.31 ± 0.28 (20/85, P = 0.021), and a decrease in the mean central foveal thickness from 373 ± 184 μm to 195 ± 137 μm at 12 months (P < 0.001). No significant intergroup difference in the achieved improvement of BCVA and decrease of central foveal thickness was observed. However, compared with the neovascular AMD group, the pachychoroid neovasculopathy group showed lower proportions of patients requiring retreatment during the maintenance phase (59.1% vs. 80.9%, P = 0.018), longer treatment-free period after loading injections (6.1 vs. 4.3 months, P = 0.006), and fewer number of injections (4.2 vs. 4.9, P = 0.031).
Anti-VEGF treatment for pachychoroid neovasculopathy showed a similar efficacy to anti-VEGF treatment for neovascular AMD in improving visual acuity during 12 months. However, eyes with pachychoroid neovasculopathy had a significantly lesser need for retreatment during the maintenance phase and longer retreatment-free period, while requiring fewer injections.
比较玻璃体内抗血管内皮生长因子（抗-VEGF）治疗肥厚脉络膜新生血管病变和新生血管性年龄相关性黄斑变性（AMD）的疗效。
回顾性纳入 22 只眼肥厚脉络膜新生血管病变和 183 只眼新生血管 AMD 患者进行分析。所有患者均为初次治疗，接受初始 3 个月的抗-VEGF 负荷剂量注射，随后根据需要进行进一步注射。从基线开始治疗 12 个月后评估视力和解剖学结局。
肥厚脉络膜新生血管病变组平均最佳矫正视力（BCVA；最小分辨角对数）从 0.50±0.32（Snellen 等价物；20/63）显著改善至 0.31±0.28（20/85，P=0.021），中央视网膜厚度从 373±184μm 降至 195±137μm（P<0.001）。两组在 BCVA 和中央视网膜厚度改善方面无显著差异。然而，与新生血管 AMD 组相比，肥厚脉络膜新生血管病变组在维持期需要再次治疗的患者比例较低（59.1% vs. 80.9%，P=0.018），负荷剂量注射后治疗无复发期较长（6.1 个月 vs. 4.3 个月，P=0.006），注射次数较少（4.2 次 vs. 4.9 次，P=0.031）。
在 12 个月内，抗 VEGF 治疗肥厚脉络膜新生血管病变在提高视力方面与抗 VEGF 治疗新生血管 AMD 疗效相当。然而，肥厚脉络膜新生血管病变眼在维持期需要再次治疗的可能性显著较小，治疗无复发期较长，而所需注射次数较少。
