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抗血管内皮生长因子治疗新生血管性年龄相关性黄斑变性后视网膜色素上皮撕裂。

Retinal Pigment Epithelium Tears after Anti-Vascular Endothelial Growth Factor Therapy for Neovascular Age-Related Macular Degeneration.

机构信息

Department of Ophthalmology, HanGil Eye Hospital, Incheon, Republic of Korea.

Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.

出版信息

Ophthalmologica. 2022;245(1):1-9. doi: 10.1159/000514991. Epub 2021 Feb 4.

Abstract

PURPOSE

The aim of this study was to assess the visual prognostic factors of retinal pigment epithelium (RPE) tears and describe their clinical features.

METHODS

The medical records of treatment-naive neovascular age-related macular degeneration patients who received intravitreal anti-vascular endothelial growth factor (VEGF) injections were retrospectively reviewed.

RESULTS

The incidence of RPE tears was 1.36% (10 out of 733 eyes). The type of anti-VEGF agent administered did not affect the incidence (p = 0.985). The median best-corrected visual acuity (BCVA) of 10 patients decreased after an RPE tear (0.4-0.6 logarithm of the minimum angle of resolution [logMAR]); however, subsequent injections restored the BCVA to a level similar to that before the RPE tear (0.4 logMAR, p = 0.436). Central macular thickness improved significantly during the study (794.4-491.9 μm, p = 0.013). The final BCVA was positively correlated with the BCVA before and immediately after the RPE tear (p = 0.025 and 0.002, respectively) and was weakly correlated with foveal involvement of the RPE tear (p = 0.061).

CONCLUSION

The incidence of RPE tears did not differ according to the type of anti-VEGF agent. The final BCVA was proportional to the BCVA before and after RPE tears. Continuous treatment with anti-VEGF after the occurrence of RPE tears can benefit the final visual acuity and macular anatomy.

摘要

目的

本研究旨在评估视网膜色素上皮(RPE)撕裂的视觉预后因素,并描述其临床特征。

方法

回顾性分析接受玻璃体内抗血管内皮生长因子(VEGF)注射治疗的未经治疗的新生血管性年龄相关性黄斑变性患者的病历。

结果

RPE 撕裂的发生率为 1.36%(733 只眼中有 10 只)。给予的抗 VEGF 药物类型不影响发生率(p=0.985)。10 例患者的最佳矫正视力(BCVA)中位数在 RPE 撕裂后下降(0.4-0.6 最小角分辨率对数[logMAR]);然而,随后的注射将 BCVA 恢复到 RPE 撕裂前的水平(0.4 logMAR,p=0.436)。研究期间中央黄斑厚度显著改善(794.4-491.9μm,p=0.013)。最终 BCVA 与 RPE 撕裂前和立即后的 BCVA 呈正相关(p=0.025 和 0.002),与 RPE 撕裂的中心凹受累呈弱相关(p=0.061)。

结论

RPE 撕裂的发生率与抗 VEGF 药物的类型无关。最终的 BCVA 与 RPE 撕裂前后的 BCVA 成正比。RPE 撕裂发生后持续进行抗 VEGF 治疗有助于提高最终视力和黄斑解剖结构。

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