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中国湿性年龄相关性黄斑变性抗VEGF治疗后视力改善的因素:12个月随访

Factors for Visual Acuity Improvement After Anti-VEGF Treatment of Wet Age-Related Macular Degeneration in China: 12 Months Follow up.

作者信息

Lu Yan, Huang Wenzhi, Zhang Yuehong, Huang Xiongfei, Zhang Xu, Ma Haizhi, Ren Guoliang, Shi Feng, Kuang Lihui, Yan Shigang, Luo Shuke, Zhang Junyan, He Jingfang, Yang Weizhong, Gao Zongyin, Leng Yunxia

机构信息

Department of Ophthalmology, Foshan Second People's Hospital, Foshan, China.

Department of Ophthalmology, Guangzhou First People's Hospital, South China University of Technology, Guangzhou, China.

出版信息

Front Med (Lausanne). 2021 Nov 11;8:735318. doi: 10.3389/fmed.2021.735318. eCollection 2021.

Abstract

To evaluate the treatment solutions and effectiveness of intravitreal ranibizumab (RBZ) or conbercept in patients with wet age-related macular degeneration (wAMD) in a real-life setting in China. The medical records of 368 patients with wAMD who started RBZ or conbercept treatment between 1 May 2014 and 30 April 2018 were evaluated. All patients were defined on fundus angiography at baseline to determine the subtype of AMD (PCV or CNV). We report visual acuity (VA) and central retinal thickness (CRT) measurements at baseline and 12 months. The average number of anti-VEGF injections was 2.1 ± 1.2. The BCVA improvement of these two groups was similar with a difference of 1.00 letter (95% CI: -1.43.4, = 0.8505). At the end of the study, a BCVA increase of at least 5 letters was determined to be a satisfactory efficacy endpoint. Several factors were related to the possible improvement in the satisfactory efficacy endpoint, including female sex (OR 2.07, 95% CI 1.223.51), number of injections (OR 1.40, 95% CI 1.121.75) and VA change at the first month (OR 13.75, 95% CI 7.4125.51). Additionally, some factors were related to the possible reduction in the satisfactory efficacy endpoint, including diabetes (OR 0.27, 95% CI 0.100.73) and disease history (OR 0.75, 95% CI 0.570.98). Our study demonstrates that anti-VEGF drugs can effectively improve BCVA and reduce CRT in AMD patients. Sex, number of injections, VA change at the first month, diabetes and disease history are the most important factors affecting visual acuity.

摘要

评估在中国现实环境中玻璃体内注射雷珠单抗(RBZ)或康柏西普治疗湿性年龄相关性黄斑变性(wAMD)患者的治疗方案及有效性。对2014年5月1日至2018年4月30日期间开始接受RBZ或康柏西普治疗的368例wAMD患者的病历进行评估。所有患者在基线时通过眼底血管造影确定AMD的亚型(息肉状脉络膜血管病变或脉络膜新生血管)。我们报告了基线和12个月时的视力(VA)和中心视网膜厚度(CRT)测量值。抗VEGF注射的平均次数为2.1±1.2。这两组的最佳矫正视力(BCVA)改善情况相似,差值为1.00字母(95%可信区间:-1.43.4,P = 0.8505)。在研究结束时,BCVA至少提高5个字母被确定为满意的疗效终点。几个因素与满意疗效终点的可能改善有关,包括女性(比值比2.07,95%可信区间1.223.51)、注射次数(比值比1.40,95%可信区间1.121.75)和第一个月的视力变化(比值比13.75,95%可信区间7.4125.51)。此外,一些因素与满意疗效终点的可能降低有关,包括糖尿病(比值比0.27,95%可信区间0.100.73)和疾病史(比值比0.75,95%可信区间0.570.98)。我们的研究表明,抗VEGF药物可有效改善AMD患者的BCVA并降低CRT。性别、注射次数、第一个月的视力变化、糖尿病和疾病史是影响视力的最重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9546/8632047/e7d66f816217/fmed-08-735318-g0001.jpg

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