Department of Ophthalmology, Helsinki University Hospital, Helsinki, Finland.
Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland.
Ophthalmologica. 2022;245(4):358-367. doi: 10.1159/000524848. Epub 2022 May 25.
We aimed to study the regional detailed visual outcome and treatment discontinuation of neovascular age-related macular degeneration (nAMD).
Clinical records of 110 patients treated for nAMD at the sole referral centre in the Helsinki region were analysed retrospectively. The follow-up was up to the fourth year.
The mean visual acuity (VA) at baseline was 56.3 (SD 16.2) letters. The mean last VA at the first year was 59.7 (20.2), and the corresponding values for the second, third, and fourth years were 60.8 (20.6), 60.0 (19.0), and 59.7 (19.3). The mean difference from baseline was +3.39 (SD 14.6), +3.59 (17.6), +0.08 (18.9), and +3.08 (14.3). The number of patients declined each year, with only 51% of the patients being in treatment until the fourth year. The patients with shorter duration of follow-up tended to have a lower baseline VA, lesser gains, and an earlier decline in VA. The VA levels at the last visit were poorer in the shorter follow group. The initial VA response predicted later VA, whereas VA at baseline, age, or sex had no effect. However, the effect vanished with a longer time in treatment.
Long-term VA stabilization was obtained in a regional material. Patients with neovascular AMD consist of cohorts with varying visual outcome and treatment time. Many of the patients benefit from the treatment for some time, however. When comparing real-world results, the outcome of the different follow-up time cohorts should be considered. This calls for new methods for analysing real-world nAMD treatment results.
我们旨在研究新生血管性年龄相关性黄斑变性（nAMD）的区域性详细视觉结果和治疗中断情况。
回顾性分析了在赫尔辛基地区唯一转诊中心接受 nAMD 治疗的 110 例患者的临床记录。随访时间长达 4 年。
基线时平均视力（VA）为 56.3（16.2）个字母。第一年的平均最后 VA 为 59.7（20.2），第二年、第三年和第四年的相应值分别为 60.8（20.6）、60.0（19.0）和 59.7（19.3）。与基线相比，平均差异为+3.39（14.6）、+3.59（17.6）、+0.08（18.9）和+3.08（14.3）。每年患者数量减少，只有 51%的患者在第四年仍在接受治疗。随访时间较短的患者基线 VA 较低，增益较小，VA 下降较早。在较短随访组中，最后一次就诊时的 VA 水平较差。初始 VA 反应预测了后期 VA，而 VA 在基线时、年龄或性别均无影响。但是，随着治疗时间的延长，这种效果消失了。
在区域性研究中获得了长期 VA 稳定。新生血管性 AMD 患者包括具有不同视觉结果和治疗时间的队列。然而，许多患者会在一段时间内受益于治疗。在比较真实世界的结果时，应考虑不同随访时间队列的结果。这需要新的方法来分析真实世界的 nAMD 治疗结果。
