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治疗和扩展方案停止后新生血管性年龄相关性黄斑变性的复发。

Recurrence of neovascular age-related macular degeneration after cessation of treat and extend regimen.

机构信息

Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki, 852- 8102, Japan.

Department of Ophthalmology, Japanese Red Cross Nagasaki Genbaku Hospital, Mori-machi, Nagasaki, 852-8511, Japan.

出版信息

Sci Rep. 2022 Aug 30;12(1):14768. doi: 10.1038/s41598-022-19062-2.

Abstract

The appropriate timing of treatment cessation after treat and extend (TAE) regimen for age-related macular degeneration has not been established. This study aimed to investigate the incidence and risk factors of recurrence after cessation of the TAE regimen. We included patients who received and discontinued the TAE regimen, after extension of the treatment interval to ≥ 12 weeks. Forty-nine patients were included in the study. The estimated recurrence rates were 33% at 1 year and 48% at 2 years after treatment cessation, respectively. Good visual acuity at cessation and a large number of injections in the 6 months before cessation were significant risk factors. Higher chances of recurrence were associated with < 0.1 logarithm of the minimum angle of resolution (logMAR) at cessation (P < 0.002). Meanwhile, five patients with visual acuity ≥ 1.0 logMAR at cessation did not show recurrence. Among the 25 recurrences, two lines of vision loss were noted in only two cases after resumed treatment. This study confirmed the importance of the number of injections in reducing recurrence and the association between visual acuity and recurrence. Recurrence is generally well-controlled with resumed treatment.

摘要

治疗和扩展(TAE)方案治疗年龄相关性黄斑变性后停止治疗的适当时机尚未确定。本研究旨在探讨停止 TAE 方案后复发的发生率和危险因素。我们纳入了在延长治疗间隔至≥12 周后接受并停止 TAE 方案治疗的患者。研究共纳入 49 例患者。治疗停止后 1 年和 2 年的估计复发率分别为 33%和 48%。停止治疗时视力较好和停止治疗前 6 个月注射次数较多是显著的危险因素。停止治疗时视力<0.1 最小角分辨率对数(logMAR)(P<0.002)与更高的复发几率相关。同时,在停止治疗时视力≥1.0 logMAR 的 5 名患者中,没有出现复发。在 25 例复发中,仅在 2 例恢复治疗后出现了两行视力损失。本研究证实了注射次数在减少复发和视力与复发之间的关联的重要性。通过恢复治疗,复发通常可以得到很好的控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f3e/9427844/5c301af16b8f/41598_2022_19062_Fig1_HTML.jpg

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