Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Ophthalmology, Graduate School of Medical Sciences, Kurume University, Kurume, Japan.
PLoS One. 2020 Oct 28;15(10):e0241343. doi: 10.1371/journal.pone.0241343. eCollection 2020.
This study aims to investigate the changes in metamorphopsia after administering the treat-and-extend regimen of anti-vascular endothelial growth factor therapy for branch retinal vein occlusion-associated macular edema. We retrospectively examined 27 patients (27 eyes) with macula edema due to branch retinal vein occlusion who received intravitreal injections of anti-vascular endothelial growth factor agents using the treat-and-extend regimen for ≥18 months. We evaluated best-corrected visual acuity, central macular thickness, macular edema recurrence, and amount of metamorphopsia quantified by M-CHARTS. The best-corrected visual acuity (logarithm of minimum angle of resolution) and central macular thickness significantly improved at 18 months compared to baseline, the median value (interquartile range [IQR]), 0.30 (0.15-0.52) and 459 (373-542) μm at baseline, and 0 (-0.08-0.16) and 267 (232-306) μm at 18 months. The M-CHARTS score (the mean of vertical and horizontal scores) significantly decreased at 1, 6, and 12 months compared to baseline, but worsened at 18 month, the median value (IQR), 0.45 (0.250-0.925), 0.4 (0.15-0.70), 0.4 (0.150-0.625), 0.4 (0.225-0.550) and 0.45 (0.225-0.750) at baseline, 1 month, 6 months, 12 months and 18 months, respectively. The median cumulative number of macular edema recurrences was 2 (IQR, 0.5-3.0) at 18 months. Simple linear regression and multivariate analyses revealed that the change in the mean M-CHARTS score at 18 months was significantly correlated with the baseline score and the cumulative number of macular edema recurrences. Anti-vascular endothelial growth factor therapy using the treat-and-extend regimen improved metamorphopsia in branch retinal vein occlusion-related macular edema in the short to mid-term follow-up period, but not in the long term. Macular edema recurrence may be associated with persistent metamorphopsia.
本研究旨在探讨分支静脉阻塞性黄斑水肿接受抗血管内皮生长因子治疗的“按需治疗”方案后，周边像差的变化。我们回顾性地检查了 27 例（27 只眼）因分支静脉阻塞导致黄斑水肿的患者，他们接受了抗血管内皮生长因子药物的玻璃体内注射，使用“按需治疗”方案进行治疗，治疗时间≥18 个月。我们通过 M-CHARTS 评估了最佳矫正视力、中心黄斑厚度、黄斑水肿复发和量化的周边像差。与基线相比，18 个月时最佳矫正视力（最小分辨角对数）和中心黄斑厚度显著提高，中位数（四分位距[IQR]）分别为 0.30（0.15-0.52）和 459（373-542）μm；0.08-0.16 和 267（232-306）μm。与基线相比，M-CHARTS 评分（垂直和水平评分的平均值）在 1、6 和 12 个月时显著降低，但在 18 个月时恶化，中位数（IQR）分别为 0.45（0.250-0.925）、0.4（0.15-0.70）、0.4（0.150-0.625）、0.4（0.225-0.550）和 0.45（0.225-0.750）。在基线、1 个月、6 个月、12 个月和 18 个月时，累积黄斑水肿复发中位数分别为 2（IQR，0.5-3.0）次。简单线性回归和多变量分析显示，18 个月时平均 M-CHARTS 评分的变化与基线评分和黄斑水肿复发的累积次数显著相关。在短期至中期随访期间，使用“按需治疗”方案的抗血管内皮生长因子治疗改善了分支静脉阻塞性黄斑水肿的周边像差，但在长期内没有改善。黄斑水肿复发可能与持续的周边像差有关。
