Berger Tyler A, Manry Matthew W, Lindsell Lucas B, Osher James M, Miller Daniel M, Foster Robert E, Riemann Christopher D, Petersen Michael R, Sisk Robert A
Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA.
Cincinnati Eye Institute, Cincinnati, OH, USA.
Clin Ophthalmol. 2021 Mar 15;15:1133-1143. doi: 10.2147/OPTH.S294789. eCollection 2021.
To evaluate if off-label Age-Related Eye Disease Study 2 (AREDS2) supplementation prevents visual and anatomical deterioration in non-proliferative Idiopathic Macular Telangiectasia Type 2 (IMT2).
This is a single-center retrospective, comparative study of 82 IMT2 eyes treated with AREDS2 from January 1st, 2013 to January 1st, 2018. The study analysis consisted of a non-comparative arm, which included all AREDS2 eyes, and a comparative arm (27 AREDS2 and 42 untreated eyes) that only included eyes with complete follow-up data. Eyes were evaluated at baseline, 12 and 24 months. Better/worse eye sub-analysis was performed in the comparative study arm. Primary outcomes were best corrected visual acuity (BCVA) and optical coherence tomography (OCT) anatomical characteristics including largest cavitation diameter, central macular thickness (CMT), and length of ellipsoid zone (EZ) loss at 24 months.
In the non-comparative arm, AREDS2 eyes showed stable BCVA (0.28 ± 0.18 logMAR at baseline vs 0.26 ± 0.19 logMAR at 24 months; p = 0.35) and OCT anatomical features after 24 months of supplementation. In the comparative arm, BCVA mean difference was greater for untreated eyes at 24 months (-0.09 ± 0.15 vs 0.03 ± 0.11 logMAR; p = <0.001). AREDS2 eyes had decreased cavitary diameter and EZ loss compared to untreated eyes at the study endpoint (p = 0.01 and p = 0.02, respectively). CMT remained stable for both cohorts throughout the study. For better/worse eye analysis, untreated eyes had worse BCVA at 24 months in both better and worse eyes (both p = 0.01). For anatomical outcomes, increases in both EZ loss (p = 0.04) and cavitary diameter (p = 0.001) among untreated eyes were only significant for eyes with worse baseline BCVA.
Our results suggest that off-label AREDS2 supplementation in non-proliferative IMT2 may prevent anatomical and visual deterioration in a subset of eyes.
评估非标签使用年龄相关性眼病研究2（AREDS2）补充剂是否能预防2型特发性黄斑毛细血管扩张症（IMT2）非增殖期患者的视力和解剖结构恶化。
这是一项单中心回顾性比较研究，纳入了2013年1月1日至2018年1月1日期间接受AREDS2治疗的82只IMT2眼。研究分析包括一个非比较组，纳入所有接受AREDS2治疗的眼睛；以及一个比较组（27只接受AREDS2治疗的眼睛和42只未治疗的眼睛），该组仅纳入有完整随访数据的眼睛。在基线、12个月和24个月时对眼睛进行评估。在比较研究组中进行了较好/较差眼亚组分析。主要结局指标为最佳矫正视力（BCVA）和光学相干断层扫描（OCT）解剖学特征，包括24个月时最大空洞直径、中心黄斑厚度（CMT）和椭圆体带（EZ）丢失长度。
在非比较组中，接受AREDS2治疗的眼睛在补充治疗24个月后，BCVA保持稳定（基线时为0.28±0.18 logMAR，24个月时为0.26±0.19 logMAR；p = 0.35），OCT解剖学特征也保持稳定。在比较组中，24个月时未治疗眼睛的BCVA平均差异更大（-0.09±0.15 vs 0.03±0.11 logMAR；p = <0.001）。在研究终点时，与未治疗的眼睛相比，接受AREDS2治疗的眼睛空洞直径减小，EZ丢失减少（分别为p = 0.01和p = 0.02）。在整个研究过程中，两个队列的CMT均保持稳定。对于较好/较差眼分析，在较好眼和较差眼中，未治疗的眼睛在24个月时BCVA均较差（均为p = 0.01）。对于解剖学结局，仅在基线BCVA较差的未治疗眼睛中，EZ丢失（p = 0.04）和空洞直径增加（p = 0.001）具有统计学意义。
我们的结果表明，在非增殖性IMT2中使用非标签AREDS2补充剂可能会预防一部分眼睛的解剖结构和视力恶化。
