Siedlecki Jakob, Koch Caroline, Schworm Benedikt, Liegl Raffael, Kreutzer Thomas, Kortuem Karsten U, Schumann Ricarda, Priglinger Siegfried G, Wolf Armin
Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstrasse 8, 80336, Munich, Germany.
BMC Ophthalmol. 2021 Jan 5;21(1):4. doi: 10.1186/s12886-020-01766-6.
To study the enlargement rate of primary geographic atrophy (GA) before and after diagnosis of a secondary choroidal neovascularization (CNV) treated with anti-vascular endothelial growth factor (VEGF) therapy.
Five hundred twenty-two consecutive eyes with primary GA were screened for the development of a complicating secondary CNV. Geographic atrophy was measured on blue autofluorescence (BAF) by two readers and calculated into mean growth rate before and after CNV diagnosis.
Ten eyes of six patients were included in the study (six study eyes with GA complicated by CNV, four GA only partner eyes). Follow-up was 1.42 ± 0.48 years before and 3.64 ± 2.73 years after CNV. There was no significant difference between mean growth rate before and after CNV (1.58 ± 0.99 vs. 1.39 ± 0.65 mm/year; p = 0.44) or between study and partner eyes (p = 0.86). Over a mean time of 3.64 ± 2.73 years, a mean of 8.3 ± 2.8 anti-VEGF injections were given. No correlation between the amount of anti-VEGF injections and change in growth rate could be observed (r = 0.58; p = 0.23).
In this pilot study, primary GA enlargement did not seem to be influenced by a secondary CNV. No association between the intensity of anti-VEGF treatment and changes in atrophy enlargement rates were found. Further studies with larger sample sizes are warranted.
研究接受抗血管内皮生长因子(VEGF)治疗的继发性脉络膜新生血管(CNV)诊断前后原发性地图样萎缩(GA)的扩大率。
对522只连续的原发性GA患眼进行筛查,以确定是否发生继发性CNV并发症。由两名阅片者通过蓝色自发荧光(BAF)测量地图样萎缩,并计算出CNV诊断前后的平均扩大率。
本研究纳入了6例患者的10只眼(6只GA合并CNV的研究眼,4只仅为GA的对照眼)。CNV诊断前的随访时间为1.42±0.48年,诊断后的随访时间为3.64±2.73年。CNV诊断前后的平均扩大率之间无显著差异(1.58±0.99 vs. 1.39±0.65mm/年;p = 0.44),研究眼与对照眼之间也无显著差异(p = 0.86)。在平均3.64±2.73年的时间里,平均进行了8.3±2.8次抗VEGF注射。未观察到抗VEGF注射量与扩大率变化之间的相关性(r = 0.58;p = 0.23)。
在这项初步研究中,原发性GA的扩大似乎不受继发性CNV的影响。未发现抗VEGF治疗强度与萎缩扩大率变化之间存在关联。有必要进行更大样本量的进一步研究。