Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, Italy.
Department of Ophthalmolgy, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Curr Eye Res. 2021 Jul;46(7):988-994. doi: 10.1080/02713683.2020.1849730. Epub 2020 Nov 25.
: To report the clinical course of choroidal neovascularization (CNV) treated with anti-vascular endothelial growth factor (VEGF) treatment in eyes with pre-existing geographic atrophy (GA).: Multicenter retrospective series. Electronic medical records, clinical notes, and multimodal retinal imaging of patients attending four tertiary referring centers with a diagnosis of unilateral CNV in the context of a pre-existing diagnosis of GA were included. GA was assessed on multimodal retinal imaging including spectral-domain optical coherence tomography (SD-OCT) scan with simultaneous near-infrared (NIR) reflectance imaging (OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany) which was acquired at baseline and every follow-up visit. GA area was measured in treated eyes and fellow eyes using NIR.: Fifty-four eyes from 27 patients (23 females, mean age 80.89 ± 7.5) were included. The mean number of injections in the treated eyes was 5.52 ± 1.9 by month 12. From baseline to month 12, stabilization of best-corrected visual acuity (BCVA) and a significant decrease ( = .002) of central macular thickness (CMT) in the treated eyes were observed; there was a slight worsening of BCVA (-2 ETDRS letters) and a non-significant change ( = .4) of CMT in the fellow eyes. GA significantly increased in both treated and untreated eyes ( < .001 and < .001, respectively) with a similar absolute increase (+2.68 mm and +2.59 mm, respectively) and growth rate (0.4 and 0.34, respectively).: In our study anti-VEGF treatment for CNV in eyes with pre-existing GA was effective in terms of decrease of exudative changes and stabilization of VA by month 12. A similar growth rate of GA between treated and untreated eyes does not support a causal relationship between anti-VEGF treatment and GA progression in this subset of patients. Further studies with a longer follow-up are mandatory to confirm these results.
: 报告在预先存在的地图状萎缩（GA）的情况下，用抗血管内皮生长因子（VEGF）治疗治疗脉络膜新生血管（CNV）的临床过程。: 多中心回顾性系列。包括在诊断为单侧 CNV 的情况下在四个三级转诊中心就诊的患者的电子病历，临床记录和多模态视网膜成像，这些患者预先诊断为 GA。在多模态视网膜成像中评估 GA，包括具有同时近红外（NIR）反射成像的光谱域光学相干断层扫描（SD-OCT 扫描）（OCT Spectralis，Heidelberg Engineering，Heidelberg，德国），该成像在基线和每次随访时获取。使用 NIR 在治疗眼和对照眼测量 GA 面积。: 27 名患者（23 名女性，平均年龄 80.89 ± 7.5）的 54 只眼被纳入研究。在治疗眼中，平均每月注射 5.52 ± 1.9 次。从基线到 12 个月，治疗眼的最佳矫正视力（BCVA）稳定，中央黄斑厚度（CMT）明显下降（ = 0.002）；在对照眼中，BCVA 略有恶化（-2 ETDRS 字母），CMT 无明显变化（ = 0.4）。在治疗眼和未治疗眼的 GA 均显著增加（均 < 0.001 和均 < 0.001），绝对增加量相似（分别增加+2.68mm 和+2.59mm），增长率相似（分别为 0.4 和 0.34）。: 在我们的研究中，抗 VEGF 治疗预先存在 GA 的 CNV 在 12 个月时通过减少渗出性改变和稳定 VA 是有效的。治疗眼和未治疗眼的 GA 增长率相似，这不能支持抗 VEGF 治疗与该患者亚组 GA 进展之间存在因果关系。需要进行具有更长随访时间的进一步研究以证实这些结果。
