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2 型增殖性黄斑毛细血管扩张症继发视网膜下新生血管膜的不同抗血管内皮生长因子治疗后解剖和视力结果的比较。

Comparison of anatomical and visual outcomes following different anti-vascular endothelial growth factor treatments in subretinal neovascular membrane secondary to type 2 proliferative macular telangiectasia.

机构信息

Department of Ophthalmology, University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mah, Bereketzade Sok. No: 2, Beyoğlu, 34421, Istanbul, Turkey.

Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2020 Jan;258(1):99-106. doi: 10.1007/s00417-019-04520-x. Epub 2019 Nov 25.

Abstract

PURPOSE

To evaluate central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and visual outcomes following different intravitreal anti-vascular endothelial growth factor (VEGF) treatments in eyes with subretinal neovascular membrane (SRNVM) due to type 2 proliferative macular telangiectasia (Mac Tel 2).

MATERIALS AND METHODS

A total of 38 eyes of 34 patients who underwent intravitreal aflibercept (IVA), intravitreal ranibizumab (IVR), or intravitreal bevacizumab (IVB) injections secondary to SRNVM due to type 2 proliferative MacTel were retrospectively reviewed. The CMT, central macular volume (CMV), best corrected visual acuity (BCVA), and SFCT were evaluated at baseline and at 2 weeks, at 1 month, and at final visits following treatment. Spectral-domain optical coherence tomography and enhanced depth optical coherence tomography were used for the analysis.

RESULTS

The mean age of the patients was 58.34 ± 12.48 years (range, 27-79 years). The mean follow-up time was 15.97 ± 6.79 months (range 5-32 months). The mean BCVA showed a statistically significant increase in each group (< 0.001). There was no statistically significant difference in BCVA changes between groups in follow-up periods. There was a significant decrease in CMT following IVA (326.4 ± 168.03 μm to 236 ± 58.33 μm) and IVB (383.71 ± 156.79 μm to 343.85 ± 146.25 μm) (p < 0.001, p = 0.004, respectively) whereas no significant decrease in CMT was observed following IVR (374.57 ± 124.28 μm to 339.71 ± 126.10 μm) (p = 0.65) between baseline and final visit. The SFCT significantly decreased following both IVB and IVR treatments (p = 0.009, p = 0.03, respectively).

CONCLUSIONS

The IVA, IVR, and IVB were found to be effective with regards to anatomical and visual outcomes in proliferative Mac Tel type 2 patients related with SRNVM. Patients receiving both IVA and IVB needed less injections compared to patients who received IVR. Moreover, IVB and IVR lead to significant decrease in SFCT whereas IVA did not show significant effect on SFCT.

摘要

目的

评估玻璃体内注射抗血管内皮生长因子(VEGF)治疗 2 型增生性黄斑毛细血管扩张症(Mac Tel 2)继发脉络膜视网膜新生血管膜(SRNVM)后中央视网膜厚度(CMT)、中心黄斑体积(CMV)、最佳矫正视力(BCVA)和脉络膜厚度的变化。

材料和方法

回顾性分析 34 例(38 只眼)因 2 型增生性 Mac Tel 相关 SRNVM 接受玻璃体内注射阿柏西普(IVA)、雷珠单抗(IVR)或贝伐单抗(IVB)治疗的患者资料。在基线、治疗后 2 周、1 个月和最终随访时评估 CMT、中央黄斑容积(CMV)、最佳矫正视力(BCVA)和脉络膜厚度(SFCT)。采用频域光学相干断层扫描和增强深度光学相干断层扫描进行分析。

结果

患者的平均年龄为 58.34±12.48 岁(27-79 岁)。平均随访时间为 15.97±6.79 个月(5-32 个月)。各组 BCVA 均有统计学显著提高(<0.001)。各组在随访期间的 BCVA 变化无统计学差异。IVA(326.4±168.03μm 至 236±58.33μm)和 IVB(383.71±156.79μm 至 343.85±146.25μm)治疗后 CMT 显著下降(均<0.001,p=0.004),而 IVR 治疗后 CMT 无显著下降(374.57±124.28μm 至 339.71±126.10μm,p=0.65)。IVB 和 IVR 治疗后 SFCT 均显著下降(p=0.009,p=0.03)。

结论

IVA、IVR 和 IVB 对 2 型增生性 Mac Tel 相关 SRNVM 患者的解剖学和视觉结局均有效。与接受 IVR 治疗的患者相比,接受 IVA 和 IVB 治疗的患者需要的注射次数更少。此外,IVB 和 IVR 可显著降低 SFCT,而 IVA 对 SFCT 无显著影响。

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