尼泊尔临床实践中视网膜静脉阻塞的治疗结果。
Treatment outcomes of retinal vein occlusion in clinical practice in Nepal.
机构信息
The University of Edinburgh, Edinburgh, UK.
Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
出版信息
BMC Ophthalmol. 2021 Feb 18;21(1):92. doi: 10.1186/s12886-021-01857-y.
BACKGROUND
This study evaluated the treatment outcomes of retinal vein occlusion (RVO) in a routine clinical practice in Nepal.
METHODS
This was a retrospective analysis of observational data of patients with RVO who attended the retina clinic of the Tilganga Institute of Ophthalmology from 1 November 2017 to 31 October 2018. The main outcome was the mean change in visual acuity (VA) at 12 months from the start of treatment. Other outcomes of interest were the mean change in central subfield thickness (CST) and the number of treatments over 12 months.
RESULTS
A total of 99 eyes (of 99 patients) with RVO (60 - branch RVO [BRVO] and 39 - central RVO [CRVO] were available for the analysis. Eyes with CRVO had worse VA and CST at baseline. Eyes in both groups were similar for age, associated factors for RVO, duration of vision loss and the presence of ischemia at baseline. The mean (95% Confidence Interval [CI]) VA change at 12 months for BRVO was - 0.35 (- 0.46, - 0.23) logMAR (p < 0.001) from a mean (SD) of 0.75 (0.42) logMAR at baseline with 63% achieving VA < 0.3 logMAR while for CRVO it was - 0.35 (- 0.46, - 0.23) logMAR (p = 0.19) from 1.13 (0.61) logMAR at baseline and VA < 0.3 logMAR in 36%. The mean (95% CI) change in CST over 12 months was - 114 (- 189, - 40) μm (p = 0.003) from a mean (SD) of 423 (151) μm at baseline for BRVO and - 184(- 276, - 91) μm (p < 0.001) from 519 (213) μm for CRVO. Patients in both groups received a median of 2 bevacizumab injections over 12 months. Around 37% eyes were lost before 12 months' observation. The mean VA and CST trajectory in these eyes at their last visit was similar to those that completed 12 months.
CONCLUSION
The outcomes of RVO over the 12 months were inferior and the number of treatments fewer than those of the clinical trials and other reports from routine clinical practice. Future studies to identify the treatment barriers are warranted to improve the treatment outcomes in our patients.
背景
本研究评估了尼泊尔常规临床实践中视网膜静脉阻塞（RVO）的治疗结果。
方法
这是一项对 2017 年 11 月 1 日至 2018 年 10 月 31 日在蒂拉冈加眼科研究所视网膜诊所就诊的 RVO 患者观察数据的回顾性分析。主要结局是治疗开始后 12 个月时视力（VA）的平均变化。其他感兴趣的结局是中央视网膜下厚度（CST）的平均变化和 12 个月内的治疗次数。
结果
共有 99 只眼睛（99 例患者）患有 RVO（60 只分支 RVO [BRVO]和 39 只中央 RVO [CRVO]）可用于分析。CRVO 眼基线时的 VA 和 CST 较差。两组的年龄、RVO 相关因素、视力丧失时间和基线缺血情况均相似。BRVO 组 12 个月时的平均（95%置信区间[CI]）VA 变化为 -0.35（-0.46，-0.23）logMAR（p<0.001），基线时的平均（SD）为 0.75（0.42）logMAR，63%的患者 VA<0.3 logMAR，而 CRVO 组为-0.35（-0.46，-0.23）logMAR（p=0.19），基线时为 1.13（0.61）logMAR，36%的患者 VA<0.3 logMAR。BRVO 组 12 个月时 CST 的平均（95%CI）变化为-114（-189，-40）μm（p=0.003），基线时 CST 平均（SD）为 423（151）μm，CRVO 组为-184（-276，-91）μm（p<0.001），基线时 CST 平均（SD）为 519（213）μm。两组患者在 12 个月内均接受中位数为 2 次贝伐单抗注射。约 37%的眼睛在 12 个月观察前丢失。这些眼睛在最后一次就诊时的平均 VA 和 CST 轨迹与完成 12 个月的眼睛相似。
结论
与临床试验和其他常规临床实践报告相比，RVO 在 12 个月内的结果较差，治疗次数较少。有必要进行未来的研究以确定治疗障碍，以改善我们患者的治疗结果。
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