From Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (H.G.K, S.H.B, S.S.K); Translational Genome Informatics Laboratory, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea (H.G.K).
Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea (T.Y.K, J.L, M.K).
Am J Ophthalmol. 2022 Dec;244:143-151. doi: 10.1016/j.ajo.2022.08.007. Epub 2022 Aug 13.
To determine potential factors associated with the long-term visual prognoses in patients with choroidal osteoma undergoing anti-vascular endothelial growth factor (VEGF) treatment.
Retrospective case series.
Patients diagnosed at tertiary high-volume hospitals between January 2000 and December 2020 were evaluated. The primary outcome measure was visual acuity at 5-year follow-up. The secondary outcome measures included factors associated with favorable vision, defined as loss of <1 line and >20/200 vision.
Of 38 eyes from 36 patients (22 female, 61%; mean age 38 years) with choroidal osteoma, 23 eyes (61%) received anti-VEGF treatment (bevacizumab 1.25mg/0.05 cc, monthly or treat-and-extend) and 65% completed the 5 years of follow-up. All treated eyes had associated chorioretinal comorbidities (subretinal fluid 91%; choroidal neovascularization 74%; subretinal hemorrhage 30%). Although there was significant vision loss by 5 years (P = .002), 12 eyes (44%) had favorable outcomes. Only tumor thickness was significantly associated with unfavorable visual outcomes (OR 917.1, 95% CI 1.0-5687.7; P = .049). The optimal cut-off point predictive of visual outcomes was 1.4 mm, and tumor thickness ≥ 1.4 mm was associated with unfavorable vision (OR 27.0, 95% CI 2.0-368.4; P = .013).
Among patients with choroidal osteoma undergoing anti-VEGF therapy, a particular patient subset presented with divergent outcomes with very poor vision. Tumor thickness appeared to be the differentiating factor and is thus a potential prognostic indicator for long-term visual prognoses.
确定接受抗血管内皮生长因子（VEGF）治疗的脉络膜骨瘤患者长期视力预后的潜在相关因素。
回顾性病例系列。
评估了 2000 年 1 月至 2020 年 12 月期间在三级高容量医院诊断的患者。主要结局测量指标是 5 年随访时的视力。次要结局测量指标包括与有利视力相关的因素，定义为视力丧失<1 行且>20/200。
36 例患者（22 名女性，61%；平均年龄 38 岁）的 38 只眼中，23 只眼（61%）接受了抗 VEGF 治疗（贝伐单抗 1.25mg/0.05cc，每月或治疗和扩展），65%完成了 5 年的随访。所有治疗眼均伴有脉络膜视网膜合并症（视网膜下液 91%；脉络膜新生血管 74%；视网膜下出血 30%）。尽管 5 年后视力显著下降（P=0.002），但仍有 12 只眼（44%）有良好的结局。只有肿瘤厚度与不良视力结局显著相关（OR 917.1，95%CI 1.0-5687.7；P=0.049）。预测视力结局的最佳截断点为 1.4mm，肿瘤厚度≥1.4mm与不良视力相关（OR 27.0，95%CI 2.0-368.4；P=0.013）。
在接受抗 VEGF 治疗的脉络膜骨瘤患者中，有一个特定的患者亚组表现出截然不同的结局，视力非常差。肿瘤厚度似乎是区分因素，因此是长期视力预后的潜在预后指标。
