Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
Turk J Ophthalmol. 2020 Oct 30;50(5):275-282. doi: 10.4274/tjo.galenos.2020.38488.
This study aimed to determine the incidence of poor response to intravitreal (IV) anti-VEGF treatment in neovascular age-related macular degeneration (nvAMD) and to define subgroups of poor responders.
A total of 235 treatment-naive eyes of 202 patients completed this prospective study. Patients younger than 50 years of age and those with a contraindication for anti-VEGF therapy were excluded. All eyes were treated with IV ranibizumab. Poor response was defined as recurrence, persistence, or worsening despite treatment. Poor responders were classified into subgroups based on progression patterns.
Of the 235 eyes, 78 (33.2%) showed poor response. Pigment epithelial detachment (PED) and occult choroidal neovascularization (CNV) were more common among poor responders (p<0.001) and 5 subgroups were identified.
Poor response to anti-VEGF treatment is not uncommon and occult CNV and PED are frequently seen in these eyes. Various subgroups can be defined based on clinical features.
本研究旨在确定新生血管性年龄相关性黄斑变性（nvAMD）患者对玻璃体内（IV）抗血管内皮生长因子（VEGF）治疗的无应答发生率，并确定无应答者的亚组。
共有 202 例患者的 235 只未经治疗的眼参与了这项前瞻性研究。排除年龄小于 50 岁的患者和有抗 VEGF 治疗禁忌证的患者。所有患者均接受 IV 雷珠单抗治疗。无应答定义为治疗后复发、持续存在或病情恶化。根据进展模式对无应答者进行亚组分类。
在 235 只眼中，78 只（33.2%）出现无应答。无应答者中色素上皮脱离（PED）和隐匿性脉络膜新生血管（CNV）更为常见（p<0.001），并确定了 5 个亚组。
抗 VEGF 治疗无应答并不少见，这些眼中常可见隐匿性 CNV 和 PED。可以根据临床特征对各种亚组进行定义。
