Çavdarlı Cemal, Çomçalı Sebile, Topcu Yılmaz Pınar, Alp Mehmet Numan
Department of Ophthalmology, Ankara City Hospital, University of Health Sciences, Bilkent, Çankaya, Ankara 06800, Turkey.
Department of Ophthalmology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
Ther Adv Ophthalmol. 2021 Apr 14;13:25158414211005305. doi: 10.1177/25158414211005305. eCollection 2021 Jan-Dec.
Randomised-controlled clinical trials (the ANCHOR and MARINA) examined the intravitreal anti-vascular endothelial growth factor (anti-VEGF) efficacy for eyes having fluorescein angiographic classic and occult (OCC) neovascular lesions. No significant difference in the treatment response between the lesion types was observed. Fundus fluorescein angiography and optical coherence tomography (OCT) are complementary devices that provide information about neovascular age-related macular degeneration (n-AMD). The aim of this retrospective study was to compare the clinical aspects of fluorescein angiographic characteristics in predominantly classic (PDC) and OCC subtypes of n-AMD treated with intravitreal ranibizumab.
Treatment-naive fluorescein angiographic OCC-n-AMD and PDC-n-AMD patients, who received monthly intravitreal ranibizumab for 3 months after baseline, and were followed-up with pro re nata injections between March 2013 and February 2018, were included. Means of the visual acuity (VA), central macular thickness (CMT), and intravitreal injection and visit numbers of the groups were compared throughout 24 months.
We included 41 eyes of PDC-n-AMD patients and 36 eyes of OCC-n-AMD patients. The mean ages were 74.5 ± 10.6 and 71.9 ± 9.4, respectively. The baseline, and 3-, 6-, 12-, 18-, and 24-month VA results of the OCC group were significantly better than those in the PDC. However, VA gain in the PDC group at 3, 6, and 12 months was significantly higher than that in the OCC group. The mean of baseline CMT of the PDC (353 ± 118 µm) was significantly higher than that in the OCC group (293 ± 64 µm). No significant differences in terms of the number of visits or injections, or CMT change from the baseline values between groups were observed.
The OCC-n-AMD patients had better baseline and follow-up VA and CMT means than the PDC-n-AMD patients. However, the PDC-n-AMD patients are expected to benefit more than the OCC-n-AMD patients in terms of VA gains.
随机对照临床试验（ANCHOR和MARINA）研究了玻璃体内注射抗血管内皮生长因子（抗VEGF）药物对患有荧光素血管造影典型和隐匿性（OCC）新生血管病变眼睛的疗效。未观察到不同病变类型之间治疗反应的显著差异。眼底荧光素血管造影和光学相干断层扫描（OCT）是互补的设备，可提供有关新生血管性年龄相关性黄斑变性（n-AMD）的信息。这项回顾性研究的目的是比较接受玻璃体内注射雷珠单抗治疗的n-AMD主要为典型（PDC）和OCC亚型的荧光素血管造影特征的临床情况。
纳入初治的荧光素血管造影显示为OCC-n-AMD和PDC-n-AMD患者，这些患者在基线后每月接受3个月的玻璃体内注射雷珠单抗，并在2013年3月至2018年2月期间根据需要进行随访注射。在24个月内比较两组的视力（VA）、中心黄斑厚度（CMT）、玻璃体内注射次数和就诊次数的平均值。
我们纳入了41例PDC-n-AMD患者的41只眼和36例OCC-n-AMD患者的36只眼。平均年龄分别为74.5±10.6岁和71.9±9.4岁。OCC组的基线以及3、6、12、18和24个月时的视力结果显著优于PDC组。然而，PDC组在3、6和12个月时的视力提高显著高于OCC组。PDC组的基线CMT平均值（353±118µm）显著高于OCC组（293±64µm）。两组在就诊次数或注射次数以及CMT相对于基线值的变化方面未观察到显著差异。
OCC-n-AMD患者的基线和随访视力及CMT平均值优于PDC-n-AMD患者。然而，就视力提高而言，预计PDC-n-AMD患者比OCC-n-AMD患者受益更多。
