Shelankova A V, Budzinskaya M V, Andreeva I V, Afanasyeva M A
Research Institute of Eye Diseases, Moscow, Russia.
Tver State Medical University, Tver, Russia.
Vestn Oftalmol. 2020;136(4. Vyp. 2):207-213. doi: 10.17116/oftalma2020136042207.
To assess the functional results of antiangiogenic therapy in patients with exudative form of age-related macular degeneration (AMD) in real clinical practice.
The study included 90 people (90 eyes) with active choroidal neovascularization (CNV) on the background of AMD. All patients were divided into 6 groups depending on the year of treatment - from 2013 to 2018, all patients were divided into 6 groups and overall the retrospective study sited at Research Institute of Eye Diseases (Moscow) lasted 8 years. All patients underwent standard ophthalmological examination including visometry, biomicroscopy and ophthalmoscopy under drug-induced mydriasis, as well as optical coherence tomography, fundus angiography and OCT-angiography.
According to the results of the analysis of OCT data obtained from 2013 to 2017, among all patients with exudative AMD, patients with types I and II of CNV and single patients with RAP prevailed, which explains the high visual acuity - about 0.5 - in all groups after the start of the treatment (table 1 and 2). In 2018, 33.3% of patients were diagnosed with RAP (the same number of eyes as with types I and II of CNV), which can be explained by the introduction of OCT-angiography into wide clinical practice. The lack of increase in visual acuity is most likely associated with a small amount of intravitreal injections (IVI) - 4.8 IVI in the first year and 3.3 IVI in the second injection year. In patients who received more than three IVI in the first year of observation, visual acuity increased from 0.49±0.03 to 0.6±0.03 (=0.04), in the case of less than three IVI in the first year, visual acuity was not changed, amounting to 0.42±0.1 before and 0.44±0.1 (=0.655) after the treatment.
Patients of all groups exhibited proportional stabilization of visual acuity, a decrease in the thickness of the retina and total macular volume. The lack of improvements of visual acuity is most likely associated with a small amount of IVI.
在实际临床实践中评估抗血管生成疗法对渗出性年龄相关性黄斑变性（AMD）患者的功能疗效。
该研究纳入了90例（90只眼）在AMD背景下存在活动性脉络膜新生血管（CNV）的患者。根据治疗年份，所有患者被分为6组——从2013年至2018年，所有患者被分为6组，这项位于眼科疾病研究所（莫斯科）的回顾性研究总共持续了8年。所有患者均接受了标准眼科检查，包括药物散瞳下的视力测量、生物显微镜检查和检眼镜检查，以及光学相干断层扫描、眼底血管造影和OCT血管造影。
根据对2013年至2017年获得的OCT数据的分析结果，在所有渗出性AMD患者中，CNV I型和II型患者以及单独的RAP患者占主导，这解释了治疗开始后所有组的高视力——约为0.5（表1和2）。2018年，33.3%的患者被诊断为RAP（与CNV I型和II型的眼数相同），这可以通过OCT血管造影在广泛临床实践中的引入来解释。视力未提高最可能与玻璃体内注射（IVI）次数少有关——第一年为4.8次IVI，第二年为3.3次IVI。在观察第一年接受超过三次IVI的患者中，视力从0.49±0.03提高到0.6±0.03（P = 0.04），如果第一年接受少于三次IVI，视力没有变化，治疗前为0.42±0.1，治疗后为0.44±0.1（P = 0.655）。
所有组的患者视力均呈现成比例的稳定，视网膜厚度和黄斑总体积减小。视力缺乏改善最可能与IVI次数少有关。
