Department of Ophthalmology, Jinan Second People's Hospital, Jinan, Shandong Province, China.
Arq Bras Oftalmol. 2023 Mar-Apr;86(2):97-104. doi: 10.5935/0004-2749.20230018.
Neovascular age-related macular degeneration is the leading cause of vision loss in the elderly. We aimed to identify baseline predictors of visual prognosis after intravitreal conbercept injection for neovascular age-related macular degeneration.
We conducted a retrospective review of 58 patients with neovascular age-related macular degeneration who were treated with intravitreal injections of conbercept 0.5 mg in routine clinical practice. Basic information such as age, sex, intraocular pressure, and disease course was collected. Best-corrected visual acuity, mean retinal sensitivity, and optical coherence tomography findings were recorded at baseline and 6 months after treatment. Logistic regression analysis was used to identify independent predictors of best-corrected visual acuity at 6 months after treatment.
After the 6-month treatment, the mean best-corrected visual acuity improved from 1.10 ± 0.42 logarithm of the minimum angle of resolution (logMAR) to 0.41 ± 0.18 logMAR, the mean retinal sensitivity increased from 5.13 ± 0.86 dB to 7.32 ± 1.21 dB, the mean central retinal thickness decreased from 440.38 ± 61.05 μm to 260.01 ± 24.86 μm, and the total number of hyperreflective dots and the number of hyperreflective dots in each retina layer were significantly reduced as compared with those before treatment (all p<0.05). Twenty-two patients showed improved vision, and 36 had unimproved vision. Multivariate analyses revealed that the number of subretinal hyperreflective dots, the state of external limiting membrane, baseline best-corrected visual acuity, and age were independent predictors of best-corrected visual acuity (all p<0.05).
Poor recovery of patients after intravitreal conbercept injection may be related to the number of subretinal hyperreflective dots, the state of external limiting membrane, baseline best-corrected visual acuity, and age, which may be used as predictors of short-term visual outcomes and should be fully evaluated before operation.
新生血管性年龄相关性黄斑变性是老年人视力丧失的主要原因。我们旨在确定接受康柏西普玻璃体腔内注射治疗新生血管性年龄相关性黄斑变性后视力预后的基线预测因素。
我们对 58 例接受康柏西普玻璃体腔内注射 0.5mg 治疗的新生血管性年龄相关性黄斑变性患者进行回顾性研究。收集了基本信息，如年龄、性别、眼压和病程。在治疗前和治疗后 6 个月记录最佳矫正视力、平均视网膜敏感度和光学相干断层扫描结果。采用逻辑回归分析确定治疗后 6 个月最佳矫正视力的独立预测因素。
治疗 6 个月后，平均最佳矫正视力从 1.10±0.42 最小分辨角对数(logMAR)提高到 0.41±0.18 logMAR，平均视网膜敏感度从 5.13±0.86dB 提高到 7.32±1.21dB，平均中央视网膜厚度从 440.38±61.05μm 降低到 260.01±24.86μm，与治疗前相比，视网膜下高反射点总数和各视网膜层高反射点数量均显著减少(均 P<0.05)。22 例患者视力改善，36 例患者视力无改善。多变量分析显示，视网膜下高反射点数量、外核层状态、治疗前最佳矫正视力和年龄是最佳矫正视力的独立预测因素(均 P<0.05)。
康柏西普玻璃体腔内注射治疗后患者视力恢复不佳可能与视网膜下高反射点数量、外核层状态、治疗前最佳矫正视力和年龄有关，这些因素可作为短期视力预后的预测指标，在手术前应充分评估。
