Li Songshan, Sun Limei, Zhao Xiujuan, Zhang Zhaotian, Luo Xiaoling, Ding Xiaoyan
State Key Laboratory of Ophthalmology, Retina Division, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Front Med (Lausanne). 2021 Aug 31;8:709584. doi: 10.3389/fmed.2021.709584. eCollection 2021.
To investigate visual function and vision-related quality of life (VR-QoL) changes in patients with myopic choroidal neovascularization (mCNV) after ranibizumab treatment. Quantitatively evaluate the objective tests of visual function (visual acuity, microperimetry, and metamorphopsia by m-Charts) before and after 3+prn (pro re neta) ranibizumab treatment for 1 year. The National Eye Institute 25-Item Visual Function Questionnaire (VFQ-25) was performed to evaluate the VR-QoL. A total of 57 eyes of 57 patients were included in this study. The median average metamorphopsia score was 0.65 before treatment and improved to 0.45 after treatment ( = 0.0003). There was also a significant difference in the average threshold, macular integrity, and proportion of patients with stable fixation by the microperimetry ( < 0.000, < 0.0001, and = 0.03, respectively). After treatment, the VR-QoL composite, general vision subscale, and vision-related mental health subscale score were increased with borderline or statistical significance ( = 0.088, = 0.0038, and = 0.012, respectively). Subgroup analysis demonstrated parallel improvement of the VR-QoL score, metamorphopsia, average macular threshold, and fixation stability in patients with or without visual acuity increase. By multiple linear regression analysis, the VFQ-25 score after anti-VEGF treatment was only associated with the baseline VFQ-25 score and macular integrity. Improvements in the VFQ-25 score were only associated with changes in the metamorphopsia score. Integral lifting in several aspects of visual function was observed in mCNV after ranibizumab treatment. Macular integrity and metamorphopsia, but not visual acuity, were associated with VR-QoL.
研究雷珠单抗治疗后近视性脉络膜新生血管（mCNV）患者的视觉功能及与视力相关的生活质量（VR-QoL）变化。对57例患者的57只眼进行3+按需（pro re nata）雷珠单抗治疗1年前后的视觉功能客观测试（视力、微视野检查以及用m-图表评估的变视症）定量评估。采用美国国立眼科研究所25项视觉功能问卷（VFQ-25）评估VR-QoL。本研究共纳入57例患者的57只眼。治疗前变视症平均得分中位数为0.65，治疗后改善至0.45（P = 0.0003）。微视野检查的平均阈值、黄斑完整性以及固视稳定患者比例也存在显著差异（分别为P < 0.000、P < 0.0001和P = 0.03）。治疗后，VR-QoL综合评分、总体视力子量表评分及与视力相关的心理健康子量表评分升高，具有临界或统计学意义（分别为P = 0.088、P = 0.0038和P = 0.012）。亚组分析显示，无论视力是否提高，患者的VR-QoL评分、变视症、黄斑平均阈值及固视稳定性均有平行改善。通过多元线性回归分析，抗VEGF治疗后的VFQ-25评分仅与基线VFQ-25评分及黄斑完整性相关。VFQ-25评分的改善仅与变视症评分的变化相关。雷珠单抗治疗后mCNV患者在视觉功能的多个方面均有整体提升。黄斑完整性和变视症而非视力与VR-QoL相关。
