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标准护理与SDM激光视力保护疗法预防新生血管性年龄相关性黄斑变性的真实世界数据比较

Real World Data Comparison of Standard Care vs SDM Laser Vision Protection Therapy for Prevention of Neovascular AMD.

作者信息

Luttrull Jeffrey K, Gray Gerry

机构信息

Ventura County Retina Vitreous Medical Group, Ventura, CA, USA.

Regulatory Pathways, Inc, Laguna Beach, CA, USA.

出版信息

Clin Ophthalmol. 2022 May 24;16:1555-1568. doi: 10.2147/OPTH.S366150. eCollection 2022.

Abstract

PURPOSE

To access the impact of regular periodic subthreshold diode micropulse laser (SDM) as Vision Protection Therapy on the rate of neovascular conversion of dry age-related macular degeneration (AMD).

METHODS

Patient unidentified clinical data aggregated by Vestrum Health, LLC (VH) from 300 retina specialists across the United States was analyzed to examine the effect of a program of regular periodic panmacular low-intensity/high-density subthreshold diode micropulse laser as vision protection therapy (VPT) compared to standard care alone, on the incidence of neovascular conversion in patients with dry age-related macular degeneration (AMD), between January 4, 2016, and September 30, 2020, producing 392,250 eyes for study.

RESULTS

After applying inclusion and exclusion criteria, eyes were matched by propensity scoring for key risk factors. This produced 830 eyes managed by standard care plus VPT, performed on average every 108 days per eye; and 8300 eyes managed with standard care alone (SCA) in a 1/10 ratio for comparison. Comparison found that VPT eyes had a markedly lower rate of neovascular conversion than SCA eyes (hazard ratio 13.04) overall, and for each propensity score matched quintile. VA worsened over time in the SCA group but improved in the VPT group.

CONCLUSION

Our findings suggest that, compared to standard care alone, VPT may markedly reduce the rate of neovascular conversion in AMD, the main cause of irreversible visual loss worldwide.

摘要

目的

评估定期进行的阈下二极管微脉冲激光(SDM)作为视力保护疗法对干性年龄相关性黄斑变性(AMD)新生血管转化发生率的影响。

方法

分析了Vestrum Health有限责任公司(VH)汇总的来自美国300位视网膜专家的患者匿名临床数据,以研究与单纯标准治疗相比,定期进行全黄斑低强度/高密度阈下二极管微脉冲激光视力保护疗法(VPT)方案对2016年1月4日至2020年9月30日期间干性年龄相关性黄斑变性(AMD)患者新生血管转化发生率的影响,共产生392,250只眼睛用于研究。

结果

应用纳入和排除标准后,通过对关键风险因素进行倾向评分来匹配眼睛。这产生了830只接受标准治疗加VPT的眼睛,平均每只眼睛每108天进行一次治疗;以及8300只仅接受标准治疗(SCA)的眼睛,以1/10的比例进行比较。比较发现,总体而言,VPT组眼睛的新生血管转化率明显低于SCA组眼睛(风险比为13.04),并且在每个倾向评分匹配的五分位数中均如此。SCA组的视力随时间恶化,而VPT组的视力有所改善。

结论

我们的研究结果表明,与单纯标准治疗相比,VPT可能会显著降低AMD患者的新生血管转化率,AMD是全球不可逆视力丧失的主要原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2bf/9148208/f218d4d320a0/OPTH-16-1555-g0001.jpg

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