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[一种用于分析视网膜积液及其对新生血管性年龄相关性黄斑变性抗VEGF治疗效果评估的差异化方法]

[A differentiated approach to analysis of retinal fluid and assessment of its effect on anti-VEGF therapy of neovascular age-related macular degeneration].

作者信息

Kamenskih T G

机构信息

Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachia St., Saratov, Russian Federation, 410012.

出版信息

Vestn Oftalmol. 2019;135(6):134-140. doi: 10.17116/oftalma2019135061134.

Abstract

Neovascular age-related macular degeneration (nAMD) causes rapid irreversible vision loss presenting a serious socio-economic problem. The recommended approach to the treatment of this pathology is the use of angiogenesis inhibitors (anti-VEGF drugs). Following the proactive principles when conducting anti-VEGF treatment helps achieve the maximum therapeutic efficacy. The evolution of diagnostic capabilities and the rising awareness of the pathogenetic features of nAMD have contributed to implementation of a more personalized approach of conducting intravitreal injections, bringing to light the necessity of determining the diagnostic criteria for repeated anti-VEGF injections. Currently, the discourse looks at the subject of OCT criteria that could act as sufficiently reliable biomarkers to help decide the change in frequency of intravitreal injections. A differentiated approach to defining the role of retinal fluid as a marker of disease activity depending on the compartment of its localization on the OCT images has not been fully determined and is of particular scientific and practical interest. The importance of correct interpretation and understanding of differences in the effects of various types of retinal fluid on the frequency of anti-VEGF injections will be discussed in this review.

摘要

新生血管性年龄相关性黄斑变性(nAMD)会导致视力迅速不可逆丧失,这是一个严重的社会经济问题。治疗这种病症的推荐方法是使用血管生成抑制剂(抗VEGF药物)。遵循积极主动的原则进行抗VEGF治疗有助于实现最大治疗效果。诊断能力的发展以及对nAMD发病机制特征认识的提高,促使采用更个性化的玻璃体内注射方法,从而凸显了确定重复抗VEGF注射诊断标准的必要性。目前,讨论的焦点是OCT标准这一主题,它可作为足够可靠的生物标志物,以帮助决定玻璃体内注射频率的变化。根据视网膜液在OCT图像上的定位区域来区分其作为疾病活动标志物的作用的方法尚未完全确定,具有特别的科学和实际意义。本综述将讨论正确解释和理解不同类型视网膜液对抗VEGF注射频率影响差异的重要性。

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