Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan, Milan, Italy; The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia.
The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia.
Am J Ophthalmol. 2019 Aug;204:105-112. doi: 10.1016/j.ajo.2019.03.001. Epub 2019 Mar 9.
To compare 5-year real-world outcomes of eyes with classic and occult choroidal neovascularization (CNV) treated with anti-vascular endothelial growth factor (anti-VEGF) injections.
Retrospective analysis from a prospectively designed observational database.
Treatment-naïve eyes diagnosed with occult or minimally or predominantly classic CNV that commenced anti-VEGF treatment between January 2007 and December 2012 were identified from a registry of neovascular age-related macular degeneration (nAMD) treatment outcomes. Baseline characteristics, visual acuity (VA) at 5 years, change in VA, time to first inactivation, number of injections, and proportion of visits graded with active nAMD over the 5 years were compared between the 3 groups.
A total of 1929 eyes from 1730 subjects (1196 occult, 289 minimally classic, and 444 predominantly classic CNV) were analyzed. Baseline VA (mean [standard deviation]) was higher in occult CNVs (56.9 [17.4] letters) than in minimally (52.9 [19.7] letters) and predominantly (49.1 [19.9] letters) classic CNVs (P = .003 and P < .0001, respectively). VA change was similar across the groups. At 5 years eyes with occult CNVs still had better VA than other CNVs. Age, lesion size, and baseline VA, but not CNV type, significantly affected final VA in the multivariate model. Predominantly classic CNVs became inactive sooner and were overall less active than other CNV types. The number of injections received was similar across the groups.
Eyes with occult CNVs had overall a better VA than other CNVs. The difference in final VA was not significant after adjusting for baseline VA. Five-year outcomes and treatment patterns were not affected by the lesion type.
比较 5 年真实世界中接受抗血管内皮生长因子（anti-VEGF）注射治疗的经典型和隐匿型脉络膜新生血管（CNV）眼的疗效。
前瞻性设计观察性数据库的回顾性分析。
从新生血管性年龄相关性黄斑变性（nAMD）治疗结果的登记处确定了 2007 年 1 月至 2012 年 12 月期间接受抗 VEGF 治疗的隐匿型或微小型或主要经典型 CNV 的未经治疗的眼。比较三组之间的基线特征、5 年时的视力（VA）、VA 变化、首次失活时间、注射次数和 5 年内有活动性 nAMD 就诊的比例。
共分析了 1730 名患者（1196 例隐匿型、289 例微小型和 444 例主要经典型 CNV）的 1929 只眼。隐匿型 CNV 的基线 VA（平均值[标准差]）较高（56.9 [17.4] 个字母），低于微小型（52.9 [19.7] 个字母）和主要经典型 CNV（P=0.003 和 P <0.0001）。各组间 VA 变化相似。5 年后，隐匿型 CNV 眼的 VA 仍优于其他 CNV。多变量模型显示，年龄、病变大小和基线 VA，但不是 CNV 类型，显著影响最终 VA。主要经典型 CNV 更早失活，且总体上比其他 CNV 类型不活跃。各组接受的注射次数相似。
隐匿型 CNV 眼的总体 VA 优于其他 CNV。调整基线 VA 后，最终 VA 的差异无统计学意义。5 年的结果和治疗模式不受病变类型的影响。
