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50 岁以上近视性脉络膜新生血管患者的基线特征及玻璃体内康柏西普治疗后的预后因素。

Baseline characteristics of myopic choroidal neovascularization in patients above 50 years old and prognostic factors after intravitreal conbercept treatment.

机构信息

Department of Ophthalmology, Xijing Hospital, Xi'an, 710032, Shaanxi, China.

Xi'an People's Hospital (Xi'an Fourth Hospital), Shaanxi Eye Hospital, Affiliated Hospital of Northwestern Polytechnical University, Xi'an, 710001, Shaanxi, China.

出版信息

Sci Rep. 2021 Apr 1;11(1):7337. doi: 10.1038/s41598-021-86835-6.

Abstract

To investigate the influence of age on the function and morphology of patients with myopic choroidal neovascularization (mCNV) and to evaluate the effect and prognostic factors of recurrence of Conbercept treatment on mCNV patients over 50 years. A total of 64 patients (64 eyes) with mCNV were enrolled in this retrospective study. The differences in baseline best-corrected visual acuity (BCVA) and morphological features on imaging between the younger group (˂ 50 years) and the older group (≥ 50 years) were analyzed. Of all, 21 eyes of 21 mCNV patients aged over 50 years who received Conbercept injection were further analyzed. Between the younger and the older group, significant differences were shown in mean BCVA (0.58 ± 0.28 vs 0.77 ± 0.31), subfoveal choroidal thickness (SFCT) (108.17 ± 78.32 μm vs 54.68 ± 39.03 μm) and frequency of vitreoretinal interface abnormalities (VIA) (2 vs 13), respectively (P < 0.05). After treated with Conbercept, the mean BCVA of 21 older mCNV patients increased from 0.83 ± 0.30 at baseline to 0.49 ± 0.24 at one year. Baseline BCVA, external limiting membrane damage, CNV area and CNV location correlated with the visual acuity at the 1-year follow-up. There were 7 (33.3%) recurrent cases during the follow-up and the risk of recurrence in patients with baseline central macular thickness (CMT) ≥ 262.86 μm was 14 times greater than that of patients with CMT < 262.86 μm. The risk of recurrence increased 1.84 times for every 100-μm increment in the CMT. Patients over 50 years with mCNV had a worse BCVA, thinner choroid, and higher risk of VIA than young mCNV patients. The standard Conbercept treatment strategy was safe and effective in mCNV patients over 50 years. As patients over 50 years with a greater CMT have a high risk of recurrence, more attention should be paid on these patients by following them up closely.

摘要

目的

探讨年龄对近视性脉络膜新生血管(mCNV)患者功能和形态的影响,并评估康柏西普治疗 50 岁以上 mCNV 患者复发的效果和预后因素。

方法

回顾性分析 64 例(64 只眼)mCNV 患者的临床资料。分析比较年轻组(<50 岁)和老年组(≥50 岁)患者的最佳矫正视力(BCVA)和影像学形态学特征的差异。进一步对 21 例(21 只眼)50 岁以上接受康柏西普治疗的 mCNV 患者进行分析。

结果

与老年组相比,年轻组患者的平均 BCVA(0.58±0.28 比 0.77±0.31)、黄斑中心凹下脉络膜厚度(SFCT)(108.17±78.32μm 比 54.68±39.03μm)和玻璃体视网膜界面异常(VIA)发生率(2 比 13)差异均有统计学意义(均为 P<0.05)。21 例老年 mCNV 患者接受康柏西普治疗后,平均 BCVA 由治疗前的 0.83±0.30 增加至治疗后 1 年的 0.49±0.24。治疗后 1 年的最佳矫正视力与治疗前的 BCVA、外核层损伤、CNV 面积和 CNV 位置有关。随访期间,有 7 例(33.3%)患者复发,基线中央黄斑厚度(CMT)≥262.86μm 的患者复发风险是 CMT<262.86μm 的患者的 14 倍。CMT 每增加 100μm,复发风险增加 1.84 倍。与年轻 mCNV 患者相比,50 岁以上 mCNV 患者的 BCVA 更差,脉络膜更薄,VIA 发生率更高。对于 50 岁以上的 mCNV 患者,标准的康柏西普治疗方案是安全有效的。由于 CMT 较大的 50 岁以上患者复发风险较高,因此应密切随访这些患者,给予更多关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f05/8016885/79dc7e1b84bb/41598_2021_86835_Fig1_HTML.jpg

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