School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Ophthalmol Retina. 2022 Jul;6(7):586-594. doi: 10.1016/j.oret.2022.02.010. Epub 2022 Feb 25.
To identify baseline OCT predictors of the 3-year visual outcome for type 3 (T3) macular neovascularization (MNV) secondary to age-related macular degeneration (AMD) treated by anti-vascular endothelial growth factor (VEGF) therapy.
Retrospective longitudinal study.
Forty eyes of 30 patients affected by exudative treatment-naive T3 MNV were enrolled.
Baseline best-corrected visual acuity (BCVA) and several baseline OCT features were assessed and included in the analysis. Univariate and multivariate analyses served to identify risk factors associated with the 3-year BCVA.
Baseline OCT features that are associated with bad or good visual outcomes of T3 MNV treated by anti-VEGF injections.
Mean baseline BCVA was 0.34 ± 0.28 logarithm of the minimum angle of resolution (LogMAR), which significantly decreased to 0.52 ± 0.37 LogMAR at the end of the 3-year follow-up (P = 0.002). In the univariate analysis, the following baseline features were associated with the 3-year BCVA outcome: baseline BCVA (P = 0.004), foveal involvement of exudation (P = 0.004), and presence of subretinal fluid (SRF; P = 0.004). In the multivariate model, baseline BCVA (P = 0.032), central macular thickness (P = 0.036), number of active T3 lesions (P = 0.034), and presence of SRF (P = 0.008) were associated with the 3-year BCVA outcome. Interestingly, 3-year BCVA was significantly lower in 19 eyes with SRF at the baseline (0.69 ± 0.42 LogMAR) than 21 eyes without SRF (0.37 ± 0.24 LogMAR; P = 0.004).
We identified structural OCT features associated with BCVA outcome after 3-year treatment with anti-VEGF injections. In contrast to previous studies on neovascular AMD, in our series, the presence of SRF at baseline was the most significant independent negative predictor of functional outcomes. Current findings may be employed to identify less favorable T3 patterns potentially deserving a more intensive treatment.
确定 3 年抗血管内皮生长因子 (VEGF) 治疗后与年龄相关性黄斑变性 (AMD) 相关的 3 型 (T3) 黄斑新生血管化 (MNV) 的基线 OCT 预测因子，用于评估治疗效果。
回顾性纵向研究。
纳入 30 名患者的 40 只眼，这些患者均为初治渗出性 T3 MNV。
评估基线最佳矫正视力 (BCVA) 和多项基线 OCT 特征，并将其纳入分析。采用单变量和多变量分析来确定与 3 年 BCVA 相关的风险因素。
与 T3 MNV 经抗 VEGF 注射治疗后视觉结局不良或良好相关的基线 OCT 特征。
平均基线 BCVA 为 0.34 ± 0.28 最小分辨角对数 (LogMAR)，在 3 年随访结束时显著降至 0.52 ± 0.37 LogMAR（P=0.002）。单变量分析显示，以下基线特征与 3 年 BCVA 结果相关：基线 BCVA（P=0.004）、渗出性病变累及中心凹（P=0.004）和存在视网膜下积液 (SRF；P=0.004)。在多变量模型中，基线 BCVA（P=0.032）、中央视网膜厚度（P=0.036）、活动性 T3 病变数量（P=0.034）和 SRF 存在（P=0.008）与 3 年 BCVA 结果相关。有趣的是，基线时有 SRF 的 19 只眼的 3 年 BCVA 显著低于无 SRF 的 21 只眼（0.69 ± 0.42 LogMAR 与 0.37 ± 0.24 LogMAR；P=0.004）。
我们确定了与抗 VEGF 治疗 3 年后 BCVA 结果相关的结构 OCT 特征。与之前关于新生血管性 AMD 的研究不同，在我们的研究系列中，基线时存在 SRF 是功能结局的最显著独立负预测因子。当前的研究结果可以用于识别潜在需要更强化治疗的预后不良的 T3 模式。
