Department of Retina and Vitreous Services, Aravind Eye Hospital, Madurai, India.
Graefes Arch Clin Exp Ophthalmol. 2021 May;259(5):1135-1143. doi: 10.1007/s00417-020-05007-w. Epub 2020 Nov 17.
To study the effect of anti-VEGFs in proliferative MacTel 2 METHODS: Sixty-four eyes of 51 patients of MacTel 2 with subretinal neovascular membrane (SRNVM) undergoing intravitreal anti-VEGF monotherapy at our institution between January 2015 and December 2018 were evaluated for visual acuity, central macular thickness (CMT) and total macular volume (TMV) using optical coherence tomography (OCT). Repeat investigations were performed at the final follow-up.
Location of SRNVM was foveal (F) in 65.6% eyes and extrafoveal (EF) in 34.4% eyes. Both CMT and TMV were lower significantly at baseline in EF-SRNVM. Fifty-six eyes received intravitreal bevacizumab and 8 eyes received ranibizumab. Average 2.14 ± 1.21 injections (range, 1-6) were administered. After a mean follow-up duration of 16.01 ± 12.96 months, the final visual acuity (VA) improved in 35.9% eyes, reduced in 28.1% and remained unchanged in 35.9% eyes. Significant improvement of VA was seen in F-SRNVM; however, overall, there was no significant improvement in visual acuity. Significant reduction in CMT was seen in F-SRNVM from 391.73 ± 152.45 μm to 293.33 ± 114.77 μm (p < 0.05) while EF-SRNVM did not show significant reduction. Total macular volume overall changed significantly from 8.79 ± 1.69 to 8.05 ± 1.27 (p < 0.05) and individually in F- and EF-SRNVM (p < 0.05). Intravitreal bevacizumab and ranibizumab monotherapy both had similar efficacy.
Anti-VEGF agents can be successfully used to treat proliferative MacTels. Macular volume measurement on OCT may be a useful parameter for evaluating EF-SRNVM and as a prognostic marker of management outcomes.
研究抗血管内皮生长因子（VEGF）在增殖性 MacTel2 中的作用
我们对 2015 年 1 月至 2018 年 12 月期间在我院接受抗 VEGF 单药治疗的 51 例 MacTel2 伴脉络膜新生血管膜（SRNVM）的 51 例 51 例患者的 64 只眼的视力、中心视网膜厚度（CMT）和总黄斑体积（TMV）进行评估，采用光学相干断层扫描（OCT）。在最后一次随访时进行重复检查。
SRNVM 的位置在黄斑中心凹（F）的有 65.6%的眼，在黄斑中心凹外（EF）的有 34.4%的眼。EF-SRNVM 的基线 CMT 和 TMV 均明显较低。56 只眼接受玻璃体腔注射贝伐单抗，8 只眼接受雷珠单抗。平均注射 2.14±1.21 次（范围，1-6 次）。平均随访 16.01±12.96 个月后，最终视力（VA）提高 35.9%，下降 28.1%，不变 35.9%。F-SRNVM 的 VA 显著改善；然而，总体上，视力没有显著提高。F-SRNVM 的 CMT 从 391.73±152.45μm 显著减少至 293.33±114.77μm（p<0.05），而 EF-SRNVM 则没有明显减少。TMV 总体上从 8.79±1.69 显著减少至 8.05±1.27（p<0.05），F-SRNVM 和 EF-SRNVM 个体也减少（p<0.05）。玻璃体腔注射贝伐单抗和雷珠单抗单药治疗均具有相似的疗效。
抗 VEGF 药物可成功用于治疗增殖性 MacTel。OCT 上的黄斑体积测量可能是评估 EF-SRNVM 的有用参数，也是管理结果的预后标志物。
