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在日本年龄相关性黄斑变性人群中,治疗后 2 年时与基线时的视力变化:10 年的观察结果。

Ten-year changes in visual acuity at baseline and at 2 years after treatment in a Japanese population with age-related macular degeneration.

机构信息

Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.

Department of Ophthalmology, Nagoya City University, Nagoya, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2021 May;259(5):1191-1198. doi: 10.1007/s00417-020-05005-y. Epub 2020 Nov 17.

Abstract

PURPOSE

We investigated 10-year changes in baseline best-corrected visual acuity (BCVA), as well as functional and anatomical changes at 1 and 2 years after initial treatment, in eyes with treatment-naïve neovascular age-related macular degeneration (nAMD).

METHODS

This retrospective, multicenter, case series reviewed patients with treatment-naïve nAMD who underwent initial treatment from 2006 to 2015, using photodynamic therapy (PDT), anti-vascular endothelial growth factor (VEGF), or a combination of PDT and anti-VEGF. BCVA and central retinal subfield thickness (CRST), were measured at baseline and at 1 or 2 years of follow-up.

RESULTS

In total, 3096 eyes of 3096 patients were included from 14 hospitals. Mean BCVA at baseline became significantly better over the 10-year study period (P < 0.001). BCVA at 1 year significantly improved from baseline in patients who underwent initial treatment from 2009 to 2015 (P = 0.001, 2009; P = 0.004, 2010; P = 0.01, 2011; P < 0.001, 2012-2015). BCVA at 2 years significantly improved from baseline in patients who underwent initial treatment from 2012 to 2015 (P < 0.001, 2012; P < 0.001, 2013-2015). CRST at 1 year decreased significantly from CRST at baseline, each year from 2006 to 2015 (P < 0.001, 2006-2015). CRST at 2 years decreased significantly from CRST at baseline, each year from 2006 to 2015 (P = 0.03, 2006; P < 0.001, 2007-2015).

CONCLUSION

Baseline BCVA with treatment-naïve nAMD tended to become better during the study period. BCVA at 1 year improved in the era of anti-VEGF; BCVA at 2 years improved in patients who underwent initial treatment in 2012 or later; and CRST decreased in each year during the study period.

摘要

目的

我们研究了未经治疗的新生血管性年龄相关性黄斑变性(nAMD)患者在初始治疗后 1 年和 2 年的最佳矫正视力(BCVA)的 10 年变化,以及功能和解剖变化。

方法

本回顾性、多中心病例系列研究纳入了 2006 年至 2015 年接受初始治疗的治疗初治 nAMD 患者,治疗方法为光动力疗法(PDT)、抗血管内皮生长因子(VEGF)或 PDT 和抗 VEGF 联合治疗。在基线和随访 1 或 2 年时测量 BCVA 和中心视网膜视网膜下厚度(CRST)。

结果

本研究共纳入来自 14 家医院的 3096 名患者的 3096 只眼。在 10 年的研究期间,BCVA 从基线开始显著提高(P<0.001)。2009 年至 2015 年接受初始治疗的患者在 1 年时的 BCVA 较基线显著改善(P=0.001,2009 年;P=0.004,2010 年;P=0.01,2011 年;P<0.001,2012-2015 年)。2012 年至 2015 年接受初始治疗的患者在 2 年时的 BCVA 较基线显著改善(P<0.001,2012 年;P<0.001,2013-2015 年)。从 2006 年至 2015 年,每年 CRST 都从基线 CRST 显著降低(P<0.001,2006-2015 年)。从 2006 年至 2015 年,每年 CRST 都从基线 CRST 显著降低(P=0.03,2006 年;P<0.001,2007-2015 年)。

结论

在研究期间,未经治疗的 nAMD 的基线 BCVA 倾向于变得更好。抗 VEGF 时代 1 年时的 BCVA 得到改善;2 年时的 BCVA 得到改善是因为患者在 2012 年或以后接受了初始治疗;在研究期间的每年 CRST 都在降低。

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