Department of Ophthalmology, The First People's Hospital of Zunyi (the Third Affiliated Hospital of Zunyi Medical University), 98 Fenghuang North Road, Huichuan District, Zunyi, Guizhou Province, 563000, China.
Department of Ophthalmology, The Affiliated Hospital of Zunyi Medical University, Zunyi, China.
BMC Ophthalmol. 2022 Nov 3;22(1):419. doi: 10.1186/s12886-022-02640-3.
The purpose of this study is to study the effect of repeated intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs on vitreomacular interface.
Neovascular age-related macular degeneration patients who received intravitreal injections of anti-VEGF drugs were included. Eyes with severe vitreous opacity, uveitis, complicated cataract surgery and previous vitrectomy were excluded. Vitreomacular interface, best corrected visual acuity (BCVA) and central retinal thickness (CRT) assessment were performed once a month for at least 3 months. The nature and time of the change event are recorded. Groups were divided according to whether vitreomacular interface change events occurred. To analyse the risk factors of vitreomacular interface changes and their influence on treatment effect.
A total of 87 eyes were evaluated. Vitreomacular interface change event occurred in 9 eyes. Pre-existing vitreomacular interface abnormality (VMIA) was a risk factor for the VMI change (P = 0.033, OR = 16.518, 95% CI: 1.258 to 216.939). 60% of interface events occurred in the first 3 months of treatment. The final BCVA of eyes with vitreomacular interface unchanged was significantly higher than that at baseline (P = 0.001), and the final CRT was also significantly lower than that at baseline (P < 0.001). The final CRT of eyes vitreomacular interface changed was significantly lower than that at baseline (P = 0.015), however, there was no statistical significance in BCVA (P = 0.468).
Intravitreal injection of anti-VEGF drugs has a certain probability to cause changes in the vitreomacular interface, and the risk is higher in eyes with pre-existing vitreomacular interface abnormality. The effect of intravitreal injections on the vitreomacular interface was concentrated in the first three injections, and subsequent increases in the number of injections did not significantly increase the risk of vitreomacular interface abnormality. Ophthalmologists should increase attention to the vitreomacular interface in the early stages of anti-VEGF therapy and counsel patients accordingly.
本研究旨在探讨反复玻璃体内注射抗血管内皮生长因子（anti-VEGF）药物对玻璃体黄斑界面的影响。
纳入接受抗 VEGF 药物玻璃体内注射的新生血管性年龄相关性黄斑变性患者。排除严重玻璃体混浊、葡萄膜炎、合并白内障手术及既往玻璃体切割术的眼。每月至少进行 1 次玻璃体黄斑界面、最佳矫正视力（BCVA）和中心视网膜厚度（CRT）评估。记录事件的性质和发生时间。根据是否发生玻璃体黄斑界面变化事件将患者分为两组。分析玻璃体黄斑界面变化的危险因素及其对治疗效果的影响。
共评估了 87 只眼。9 只眼发生玻璃体黄斑界面变化事件。玻璃体黄斑界面异常（VMIA）是玻璃体黄斑界面改变的危险因素（P=0.033，OR=16.518，95%CI：1.258 至 216.939）。60%的界面事件发生在治疗的前 3 个月。玻璃体黄斑界面无改变眼的最终 BCVA 明显高于基线（P=0.001），最终 CRT 也明显低于基线（P<0.001）。玻璃体黄斑界面改变眼的最终 CRT 明显低于基线（P=0.015），但 BCVA 无统计学意义（P=0.468）。
玻璃体内注射抗 VEGF 药物有一定概率引起玻璃体黄斑界面改变，且存在玻璃体黄斑界面异常的眼风险更高。玻璃体内注射对玻璃体黄斑界面的影响集中在前 3 次注射，随后增加注射次数不会显著增加玻璃体黄斑界面异常的风险。眼科医生应在抗 VEGF 治疗的早期阶段更加关注玻璃体黄斑界面，并相应地对患者进行咨询。
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