Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Acta Ophthalmol. 2021 Dec;99(8):e1360-e1365. doi: 10.1111/aos.14831. Epub 2021 Mar 5.
To report real-world experiences on driving vision in patients with neovascular age-related macular degeneration (AMD) undergoing intravitreal anti-VEGF treatment.
Retrospective cohort study of treatment-naïve patients with neovascular AMD commenced in anti-VEGF treatment (n = 416) and followed for 4 years in a pro re nata treatment regimen. Monocular best-corrected visual acuity (BCVA) measured using ETDRS was performed on the treatment eye at all visits and on the fellow eye at baseline, every 6 months, and upon any patient-reported change in vision. Driving vision was defined as BCVA in the best-seeing eye of ≥70 ETDRS letters (equivalent to ≥0.5 Snellen) corresponding to the minimum BCVA required in many countries.
Driving vision was present in 280 patients (67%) and was sustained in 86%, 74%, 65% and 59% of the patients at 1, 2, 3 and 4 years, respectively. Lower BCVA in the best-seeing eye predicted loss of driving vision. In patients without driving vision at baseline, driving vision was regained in 29%, 36%, 39% and 41% of the patients at 1, 2, 3 and 4 years, respectively; but only 35% sustained driving vision after the first year. Lower age and higher BCVA in best-seeing eye predicted regain of driving vision.
Driving vision can be sustained in the majority of the patients if they have driving vision at baseline. This study provides important prognostic information for patients with neovascular AMD.
报告接受抗血管内皮生长因子（VEGF）治疗的新生血管性年龄相关性黄斑变性（AMD）患者的现实生活中驾驶视力的经验。
对开始接受抗 VEGF 治疗的初治新生血管性 AMD 患者进行回顾性队列研究（n=416），并按照按需治疗方案随访 4 年。所有就诊时均对治疗眼进行最佳矫正视力（BCVA）测量，使用 ETDRS 进行测量，并在基线时对对侧眼进行测量，此后每 6 个月测量一次，以及在患者报告视力发生任何变化时进行测量。驾驶视力定义为最佳视力眼的 BCVA≥70 ETDRS 字母（相当于≥0.5 Snellen），这相当于许多国家要求的最低 BCVA。
280 名患者（67%）存在驾驶视力，分别有 86%、74%、65%和 59%的患者在 1、2、3 和 4 年时能够维持驾驶视力。最佳视力眼的 BCVA 较低预示着驾驶视力丧失。在基线时没有驾驶视力的患者中，分别有 29%、36%、39%和 41%的患者在 1、2、3 和 4 年时恢复了驾驶视力，但只有 35%的患者在第一年之后维持了驾驶视力。年龄较低和最佳视力眼的 BCVA 较高预示着恢复驾驶视力。
如果患者在基线时存在驾驶视力，则大多数患者可以维持驾驶视力。本研究为新生血管性 AMD 患者提供了重要的预后信息。
