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康柏西普治疗视网膜静脉阻塞继发黄斑水肿复发的预后因素研究:一项 FALCON 研究的事后分析。

Prognostic Factor Study of Macular Edema Recurrence in Retinal Vein Occlusion after Conbercept Treatment: A Post Hoc Analysis of the FALCON Study.

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China.

Department of Retina, The Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China.

出版信息

Comput Math Methods Med. 2022 Jul 29;2022:3616044. doi: 10.1155/2022/3616044. eCollection 2022.

Abstract

OBJECTIVE

The study was aimed at exploring the potential predictive factors associated with the recurrence of macular edema (ME) secondary to vein occlusion (RVO) after intravitreal antivascular endothelial growth factor (VEGF) loading treatment in the FALCON study.

METHODS

This is a post hoc analysis of 30 patients with central RVO and 30 patients with branch RVO. All patients received a monthly administration of intravitreal conbercept during the 3-month loading phase and pro re nata (PRN) treatment during the 6-month follow-up period. Based on the recurrence of ME at the first follow-up visit, patients were classified into the recurrence group or nonrecurrence group. The primary endpoint was to explore the risk factors for recurrence among baseline characteristics, fluorescein angiography (FA) patterns, and optical coherence tomography (OCT).

RESULTS

In general, 38 patients (64.4%) experienced ME recurrence at the first follow-up visit (3 months), regardless of disease type ( = 0.32). Significant improvements in VA were noted in both the nonrecurrence and recurrence groups ( < 0.001), however, without significant between-group differences ( = 0.1). A significant reduction in CRT in both groups ( < 0.001) was identified, and patients without recurrence showed a greater reduction in CRT compared with those with recurrence ( < 0.001). In addition, logistic regression analyses indicated the corrections of ME recurrence with baseline macular volume and the disruption of the outer limiting membrane at the fovea.

CONCLUSION

This study suggested that OCT parameters, including baseline macular volume and outer limiting membrane disruption, and reduction in CRT after loading therapy were more predictive of ME recurrence than FA patterns or visual changes following conbercept loading therapy.

摘要

目的

本研究旨在探讨 FALCON 研究中玻璃体内抗血管内皮生长因子(VEGF)加载治疗后静脉阻塞(RVO)继发黄斑水肿(ME)复发的相关潜在预测因素。

方法

这是一项对 30 例中心性 RVO 患者和 30 例分支性 RVO 患者的回顾性分析。所有患者在 3 个月的加载期内每月接受玻璃体内康柏西普治疗,在 6 个月的随访期内接受按需治疗。根据首次随访时 ME 的复发情况,患者分为复发组或未复发组。主要终点是探讨基线特征、荧光素血管造影(FA)模式和光学相干断层扫描(OCT)中与复发相关的危险因素。

结果

一般来说,38 例患者(64.4%)在首次随访(3 个月)时出现 ME 复发,与疾病类型无关(=0.32)。无论在复发组还是未复发组,VA 均有显著改善(<0.001),但两组间无显著差异(=0.1)。两组 CRT 均显著降低(<0.001),未复发组 CRT 降低幅度大于复发组(<0.001)。此外,逻辑回归分析表明,基线黄斑体积和黄斑中心凹外限膜中断与 ME 复发的校正有关。

结论

本研究表明,OCT 参数,包括基线黄斑体积和黄斑中心凹外限膜中断,以及加载治疗后 CRT 的降低,比 FA 模式或康柏西普加载治疗后的视力变化更能预测 ME 的复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bb0/9355755/c3c0574b3ade/CMMM2022-3616044.001.jpg

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