Spooner Kimberly, Fraser-Bell Samantha, Hong Thomas, Phan Long, Wong James G, Chang Andrew
Sydney Retina, Sydney, New South Wales, Australia.
The University of Sydney, The Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, New South Wales, Australia.
Ophthalmol Retina. 2021 Jun;5(6):511-518. doi: 10.1016/j.oret.2020.09.019. Epub 2020 Sep 29.
To report the 10-year outcomes of eyes with neovascular age-related macular degeneration (nAMD) treated with vascular endothelial growth factor (VEGF) inhibitors.
Ten-year, retrospective cohort study.
A total of 1046 patients who commenced treatment with anti-VEGF for nAMD.
Anti-VEGF-naïve eyes diagnosed with nAMD that commenced treatment between November 2006 and December 2009 were identified. Data collected included the baseline demographics, visual acuity (VA), and number of intravitreal injections. Baseline fundus fluorescein angiograms and OCT images were graded for choroidal neovascularization type. OCT images were graded for central macular thickness (CMT) and the presence of fluid over the 10 years.
Change in vision at 10 years. Secondary outcomes included the proportion of eyes with 20/40 vision or better and 20/200 or worse, the proportion of eyes that were dry on OCT imaging, and the number of injections.
Of 1046 eligible eyes, 10-year data were available for 293 (28%), which were included in the analyses. Eyes received 58.1 (standard deviation [SD], 33.6) injections during the 10 years. The mean CMT decreased from 355.5 μm (SD, 107.8 μm) to 264.2 (SD, 79.5) μm (P < 0.001). The median baseline VA was 60 (interquartile range [IQR], 45-70) letters, which improved by 9 (IQR, 1-14) letters after the first year of treatment (P < 0.001). Over the 10-year period, these initial gains were lost over time with a final VA change of +3 letters (IQR, 8-10 letters, P = 0.162). However, the proportion of eyes with VA 20/40 or better increased from 29% at baseline to 35% at 10 years (P < 0.001). The proportion of eyes at baseline with VA 20/200 or worse was 14% and 17% at 10 years.
On average, eyes with nAMD maintained starting VA when treated with VEGF inhibitors for 10 years. With ongoing regular treatment, a greater proportion of eyes achieved VA of 20/40 or better at 10 years than at presentation.
报告接受血管内皮生长因子（VEGF）抑制剂治疗的新生血管性年龄相关性黄斑变性（nAMD）患眼的10年治疗结果。
10年回顾性队列研究。
共有1046例开始接受抗VEGF治疗nAMD的患者。
确定2006年11月至2009年12月期间开始治疗的初治nAMD患眼。收集的数据包括基线人口统计学资料、视力（VA）和玻璃体内注射次数。对基线眼底荧光血管造影和OCT图像进行脉络膜新生血管类型分级。对OCT图像进行10年期间的中心黄斑厚度（CMT）和积液情况分级。
10年时视力的变化。次要观察指标包括视力达到20/40或更好以及20/200或更差的患眼比例、OCT成像显示干燥的患眼比例以及注射次数。
在1046例符合条件的患眼中，293例（28%）有10年数据并纳入分析。患眼在10年期间接受了58.1次（标准差[SD]，33.6）注射。平均CMT从355.5μm（SD，107.8μm）降至264.2（SD，79.5）μm（P<0.001）。基线视力中位数为60（四分位间距[IQR]，45 - 70）字母，治疗第1年后提高了9（IQR，1 - 14）字母（P<0.001）。在10年期间，这些最初的视力提高随时间逐渐丧失，最终视力变化为+3字母（IQR，8 - 10字母，P = 0.162）。然而，视力达到20/40或更好的患眼比例从基线时的29%增加到10年时的35%（P<0.001）。基线时视力为20/200或更差的患眼比例在10年时为17%，基线时为14%。
平均而言，nAMD患眼接受VEGF抑制剂治疗10年时维持了起始视力。持续进行规律治疗后，10年时视力达到20/40或更好的患眼比例高于初诊时。
