Department of Ophthalmology, Tuzla State Hospital, İçmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla/İstanbul, 34947, Istanbul, Turkey.
Department of Ophthalmology, Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
Int Ophthalmol. 2022 Sep;42(9):2729-2740. doi: 10.1007/s10792-022-02261-1. Epub 2022 Mar 31.
PURPOSE: To evaluate anatomical and visual results of eyes with naive myopic choroidal neovascularization (mCNV) in patients treated with intravitreal anti-vascular endothelial growth factor (VEGF) therapies. MATERIAL AND METHODS: This is a retrospective, non-randomized, comperative, intervetional study. One hundred fourteen eyes of 114 patients with mCNV who underwent intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR) or intravitreal aflibercept (IVA) monotherapy injections were enrolled into the study. The best corrected visual acuity (BCVA), central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were compared among the groups during the follow-up periods at the beginning, months 1, 3, 6, 12, and the final visit. RESULTS: The mean age of the patients was 47.76 ± 10.57 years (range, 33-72 years) and the mean follow-up period was 23.34 ± 6.81 months (range, 13-38 months). The mean BCVA denoted a significantly improve at each group (p < 0.05). In terms of an inter-group analysis of all 3 groups, at months 1, 6, and 12 and final visit, the BCVA were statistically significantly better in the IVA group when compared to both IVB and IVR groups (p = 0.021, p = 0.032, p = 0.024, p = 0.012). There was a significant decrease in CMT following IVB (236.49 ± 40.91 μm-190.74 ± 50.12 μm), IVA (232.91 ± 46.29 μm-193.73 ± 46.81 μm) and IVR (234.78 ± 45.37 μm-192.21 ± 37.27 μm) between baseline and final visit (p = 0.018, p = 0.002, p < 0.001, respectively). There was a statistically significant decrease in SFCT values between baseline and final examination only in the IVA group (p < 0.001). The mean number of injections were 9.18 ± 3.18 (range; 3 to 13) in IVB, 6.46 ± 2.93 (range; 3-11) in IVR and 4.45 ± 1.42 (range; 2-7) in IVA (p = 0.028). CONCLUSION: All three anti-VEGFs were found to be effective in terms of visual results in patients with mCNV. However, we demonstrated that IVA reduces the need for anti-VEGF when compared to patients who received both IVB and IVR. Furthermore, IVA induced a prominent reduction in SFCT, whereas IVR and IVB did not have a significant action on SFCT.
目的：评估接受抗血管内皮生长因子（VEGF）治疗的单纯性近视脉络膜新生血管（mCNV）患者的解剖学和视觉结果。
材料和方法：这是一项回顾性、非随机、对照、干预性研究。114 例 mCNV 患者的 114 只眼接受了玻璃体内贝伐单抗（IVB）、玻璃体内雷珠单抗（IVR）或玻璃体内阿柏西普（IVA）单药注射治疗。在基线、第 1、3、6、12 个月和最终随访期间，比较各组的最佳矫正视力（BCVA）、中心黄斑厚度（CMT）和中心凹下脉络膜厚度（SFCT）。
结果：患者的平均年龄为 47.76±10.57 岁（范围 33-72 岁），平均随访时间为 23.34±6.81 个月（范围 13-38 个月）。所有组的平均 BCVA 均有显著改善（p<0.05）。在所有 3 组的组间分析中，在第 1、6 和 12 个月以及最终随访时，IVA 组的 BCVA 与 IVB 和 IVR 组相比均有统计学显著改善（p=0.021，p=0.032，p=0.024，p=0.012）。与基线相比，IVB（236.49±40.91μm-190.74±50.12μm）、IVA（232.91±46.29μm-193.73±46.81μm）和 IVR（234.78±45.37μm-192.21±37.27μm）的 CMT 均显著降低（p=0.018，p=0.002，p<0.001）。仅在 IVA 组中，基线与最终检查之间 SFCT 值有统计学显著下降（p<0.001）。IVB 组的平均注射次数为 9.18±3.18（范围 3-13），IVR 组为 6.46±2.93（范围 3-11），IVA 组为 4.45±1.42（范围 2-7）（p=0.028）。
结论：三种抗 VEGF 药物在 mCNV 患者的视力结果方面均有效。然而，我们发现与接受 IVB 和 IVR 治疗的患者相比，IVA 减少了对抗 VEGF 的需求。此外，IVA 可显著降低 SFCT，而 IVR 和 IVB 对 SFCT 无明显作用。
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