Department of Ophthalmology, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan.
Department of Ophthalmology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.
PLoS One. 2020 Mar 10;15(3):e0229342. doi: 10.1371/journal.pone.0229342. eCollection 2020.
We aimed to construct a better model for predicting treatment outcomes of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration (nAMD) using the concentrations of aqueous humour proteins at baseline and during treatment. From the data of 48 treatment-naïve nAMD eyes that received intravitreal ranibizumab pro re nata for up to 12 months, we used the aqueous humour concentrations of C-X-C motif chemokine ligand 1 (CXCL1), CXCL12, CXCL13, interferon-γ-induced protein 10, monocyte chemoattractant protein 1 (MCP-1), C-C motif chemokine ligand 11, interleukin 6 (IL-6), IL-10, and matrix metalloproteinase 9 (MMP-9). After stepwise regression, multivariate analysis was performed to identify which predictors were significantly associated with best-corrected visual acuity (BCVA) changes and the number of injections. The results demonstrated that besides male sex (β coefficient = -0.088, P = 0.040) and central retinal thickness (β coefficient = 0.00051 per μm, P = 0.027), MCP-1 (β coefficient = 0.44, P < 0.001) and IL-10 (β coefficient = -0.16, P = 0.033) were significantly correlated with baseline BCVA. Additionally, high MCP-1 at baseline (β coefficient = -0.20, P = 0.015) and low CXCL13 at baseline (β coefficient = 0.10, P = 0.0054) were independently associated with better BCVA change at 12 months. High MMP-9 at the first injection (β coefficient = 0.56, P = 0.01), CXCL12 at the third injection (β coefficient = 0.10, P = 0.0002), and IL-10 at the third injection (β coefficient = 1.3, P = 0.001) were predictor variables associated with the increased number of injections. In conclusion, aqueous humour protein concentrations may have predictive abilities of BCVA change over 12 months and the number of injections in pro re nata treatment of exudative nAMD.
我们旨在构建一个更好的模型，以使用基线和治疗期间房水蛋白浓度预测抗血管内皮生长因子治疗新生血管性年龄相关性黄斑变性（nAMD）的治疗结果。从接受玻璃体腔内雷珠单抗按需治疗长达 12 个月的 48 例未经治疗的 nAMD 眼的数据中，我们使用房水中 C-X-C 基序趋化因子配体 1（CXCL1）、CXCL12、CXCL13、干扰素-γ诱导蛋白 10、单核细胞趋化蛋白 1（MCP-1）、C-C 基序趋化因子配体 11、白细胞介素 6（IL-6）、IL-10 和基质金属蛋白酶 9（MMP-9）的浓度。经过逐步回归，进行多变量分析以确定与最佳矫正视力（BCVA）变化和注射次数显著相关的预测因子。结果表明，除了男性性别（β系数=-0.088，P=0.040）和中心视网膜厚度（β系数=每μm0.00051，P=0.027）外，MCP-1（β系数=0.44，P<0.001）和 IL-10（β系数=-0.16，P=0.033）与基线 BCVA 显著相关。此外，基线时 MCP-1 水平较高（β系数=-0.20，P=0.015）和基线时 CXCL13 水平较低（β系数=0.10，P=0.0054）与 12 个月时 BCVA 变化更好独立相关。首次注射时 MMP-9 水平较高（β系数=0.56，P=0.01）、第三次注射时 CXCL12 水平较高（β系数=0.10，P=0.0002）和第三次注射时 IL-10 水平较高（β系数=1.3，P=0.001）是与增加注射次数相关的预测变量。总之，房水蛋白浓度可能具有预测 12 个月内 BCVA 变化和渗出性 nAMD 按需治疗中注射次数的能力。
