Budzinskaya M V, Shelankova A V, Andreeva A A, Plyukhova A A, Afanasyeva M A
Research Institute of Eye Diseases, Moscow, Russia.
Vestn Oftalmol. 2021;137(5):7-13. doi: 10.17116/oftalma20211370517.
The neovascular form of age-related macular degeneration (AMD) is characterized by growth of newly formed vessels, accumulation of fluid and, in most cases, presence of retinal pigment epithelium detachment. Depending on its localization in relation to retinal pigment epithelium (RPE), macular neovascularization (MNV) can be considered type 1 when it is located under the RPE, and type 2 when it is invading the RPE and the neurosensory part of the retina.
To conduct a retrospective analysis of the use of anti-VEGF therapy in AMD patients with types I and II of MNV.
The study enrolled 89 AMD patients (89 eyes) with active MNV who have been under observation for 3 years. In the course of treatment all patients underwent standard ophthalmological examination that included visometry, biomicroscopy and ophthalmoscopy with mydriasis, as well as optical coherence tomography.
Anti-VEGF therapy was found to stabilize best corrected visual acuity (BCVA) in both types of MNV (I and II). Comparison of the intraretinal and subretinal fluids (IRF and SRF) revealed that initially neuroepithelium detachment is more frequent (approximately in 90% of eyes) than IRF (30-40%). Antiangiogenic therapy is associated with better resorption of SRF, by the third year of the follow-up the neuroepithelium detachment is visualized in 60% of patients, while IRF remains and is observed in 40% of cases.
Antiangiogenic therapy has shown good functional and morphological effectiveness in both first and second types of MNV.
年龄相关性黄斑变性（AMD）的新生血管型特征为新生血管生长、液体蓄积，且在大多数情况下存在视网膜色素上皮脱离。根据黄斑新生血管（MNV）相对于视网膜色素上皮（RPE）的位置，当MNV位于RPE下方时可视为1型，当它侵入RPE和视网膜神经感觉部分时则为2型。
对1型和2型MNV的AMD患者使用抗VEGF治疗进行回顾性分析。
该研究纳入了89例患有活动性MNV的AMD患者（89只眼），对其进行了3年的观察。在治疗过程中，所有患者均接受了标准眼科检查，包括视力测量、生物显微镜检查、散瞳眼底检查以及光学相干断层扫描。
发现抗VEGF治疗可使两种类型的MNV（1型和2型）的最佳矫正视力（BCVA）稳定。视网膜内液和视网膜下液（IRF和SRF）的比较显示，最初神经上皮脱离比IRF更常见（约90%的眼）（IRF为30 - 40%）。抗血管生成治疗与SRF更好的吸收相关，到随访第三年时，60%的患者可见神经上皮脱离，而40%的病例中仍存在并观察到IRF。
抗血管生成治疗在1型和2型MNV中均显示出良好的功能和形态学效果。
