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雷珠单抗联合或不联合维替泊芬光动力疗法治疗息肉状脉络膜血管病变: EVEREST II 研究中视觉和解剖学应答的预测因素。

RANIBIZUMAB WITH OR WITHOUT VERTEPORFIN PHOTODYNAMIC THERAPY FOR POLYPOIDAL CHOROIDAL VASCULOPATHY: Predictors of Visual and Anatomical Response in the EVEREST II Study.

机构信息

Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, National University of Singapore, Singapore.

Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore.

出版信息

Retina. 2021 Feb 1;41(2):387-392. doi: 10.1097/IAE.0000000000002902.

DOI:10.1097/IAE.0000000000002902
PMID:33475271
Abstract

PURPOSE

To evaluate the demographic and imaging factors at baseline and Month 3 (M3) that predict visual or anatomical responses at Month 12 (M12) in the EVEREST-II study for polypoidal choroidal vasculopathy.

METHODS

Post-hoc analysis of 322 participants in the EVEREST-II study. Patient factors, best-corrected visual acuity (BCVA), treatment, and imaging parameters at baseline and M3 were evaluated with respect to outcomes at M12 using univariate and multivariable analysis.

RESULTS

Younger age (P < 0.001) and lower baseline BCVA (P < 0.001) were associated with higher BCVA gains at M12. Smaller baseline polypoidal lesion area was associated with higher BCVA gains at M12 only in the ranibizumab monotherapy arm (P = 0.008). Central subfield thickness at M3, area of branching vascular network at M3, BCVA at M3, and age were associated with change in BCVA from M3 at M12. Higher odds of fluid-free retina at M12 were associated with lower baseline central subfield thickness (P = 0.006), treatment with combination therapy (baseline and M3 models; P < 0.001), and absence of subretinal fluid at M3 (P < 0.001).

CONCLUSION

Several imaging parameters at baseline and M3 can predict treatment outcome. The interaction between treatment arm and total polypoidal lesion area suggests this feature may assist selecting between initial ranibizumab monotherapy or combination therapy.

摘要

目的

评估 EVEREST-II 研究中基线和第 3 个月(M3)的人口统计学和影像学因素,以预测息肉样脉络膜血管病变的第 12 个月(M12)的视力或解剖学应答。

方法

EVEREST-II 研究中 322 名参与者的事后分析。使用单变量和多变量分析,根据 M12 时的结果评估基线和 M3 时的患者因素、最佳矫正视力(BCVA)、治疗和影像学参数。

结果

年龄较小(P < 0.001)和基线 BCVA 较低(P < 0.001)与 M12 时更高的 BCVA 增益相关。仅在雷珠单抗单药治疗组中,基线息肉样病变面积较小与 M12 时更高的 BCVA 增益相关(P = 0.008)。M3 时的中央视网膜厚度、M3 时的分支血管网络面积、M3 时的 BCVA 和年龄与 M12 时从 M3 开始的 BCVA 变化相关。M12 时无液性视网膜的可能性与基线中央视网膜厚度较低(P = 0.006)、联合治疗(基线和 M3 模型;P < 0.001)和 M3 时无视网膜下液相关(P < 0.001)相关。

结论

基线和 M3 的几个影像学参数可以预测治疗结果。治疗组与总息肉样病变面积之间的相互作用表明,该特征可能有助于在初始雷珠单抗单药治疗或联合治疗之间进行选择。

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