Department of Ophthalmology, The University of Auckland, 85 Park Road, Grafton, Auckland, 1051, New Zealand.
Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand.
BMC Ophthalmol. 2022 Jul 28;22(1):325. doi: 10.1186/s12886-022-02551-3.
A 3-year single-centre, retrospective, comparative, non-randomized cohort study to describe the long-term outcomes of treatment-naïve, Caucasian and non-Caucasian eyes with polypoidal choroidal vasculopathy (PCV) after treatment with predominantly Bevacizumab monotherapy or in combination with rescue photodynamic therapy (PDT).
Demographics, visual outcomes, optical coherence tomography (OCT) and treatment data were collected up to 3 years after the first visit. Stratified analysis according to ethnicity and baseline vision was performed to identify factors predictive of long-term visual improvement and maintenance.
A total of 89 eyes with PCV were identified, of which 14 received rescue verteporfin PDT. There was an equal distribution between Caucasian and non-Caucasian individuals. Non-Caucasians present at a younger age (67.3 vs. 76.0 years, p = 0.002), have a higher proportion of foveal involvement (80.9%, vs.54.2% p = 0.007), choroidal hyperpermeability (50% vs 25.8%, p = 0.013) and lower baseline visual acuity (53.1 vs. 63.3 letters, p = 0.008). Mean visual acuity (VA) gain was + 8.9 letters and + 5.0 letters at 1 and 3 years of follow-up, respectively. Non-Caucasian individuals had a lower mean final visual acuity (VA) (54.7 vs. 70.5, respectively; P < 0.001) and net gain in VA (+ 2.0 vs. + 7.6 letters, p = 0.581) compared to Caucasian individuals. The mean total number of injections given over 3 years was 14.
Most patients treated with predominantly Bevacizumab anti-vascular endothelial growth factor (VEGF) monotherapy achieved sustained visual acuity gains out to 3 years. Due to ethnic-specific differences in presenting PCV phenotypes, non-Caucasians presented with lower baseline VA and had poorer long-term visual outcomes.
本研究为一项为期 3 年的单中心回顾性、非随机对照队列研究，旨在描述初治的白种人和非白种人息肉状脉络膜血管病变（PCV）患者单纯使用贝伐单抗或联合光动力疗法（PDT）治疗后的长期结局。
收集患者首次就诊后 3 年内的人口统计学、视力结果、光学相干断层扫描（OCT）和治疗数据。根据种族和基线视力进行分层分析，以确定预测长期视力改善和维持的因素。
共纳入 89 只 PCV 眼，其中 14 只眼接受了挽救性维替泊芬 PDT 治疗。白种人和非白种人患者的分布比例相当。非白种人患者年龄更小（67.3 岁 vs. 76.0 岁，p=0.002），更易出现黄斑累及（80.9% vs. 54.2%，p=0.007）、脉络膜高通透性（50% vs. 25.8%，p=0.013）和更低的基线视力（53.1 个字母 vs. 63.3 个字母，p=0.008）。1 年和 3 年的平均视力（VA）增益分别为+8.9 个字母和+5.0 个字母。非白种人患者的最终平均视力（VA）（54.7 个字母 vs. 70.5 个字母；P<0.001）和 VA 净增益（+2.0 个字母 vs. +7.6 个字母，p=0.581）均低于白种人患者。3 年内平均注射总次数为 14 次。
大多数接受贝伐单抗抗血管内皮生长因子（VEGF）单药治疗的患者在 3 年内获得了持续的视力提高。由于 PCV 表型在不同种族间存在特异性差异，非白种人患者的基线 VA 较低，长期视力结局较差。
