Department of Ophthalmology, Kim's Eye Hospital, Seoul, South Korea.
Retina. 2023 Aug 1;43(8):1264-1273. doi: 10.1097/IAE.0000000000003797.
To evaluate the incidence and timing of pigment epithelial detachment (PED) and subretinal fluid (SRF) development in type 3 macular neovascularization.
This retrospective study included 84 patients who were diagnosed with treatment-naïve type 3 macular neovascularization who did not show SRF at diagnosis. All patients were initially treated with three loading injections of ranibizumab or aflibercept. After the initial loading injections, as-needed regimen was performed for retreatment. The development of either PED or SRF was identified. The incidence and timing of PED development in patients without PED at diagnosis and that of SRF development in patients with PED at diagnosis were evaluated.
The mean follow-up period was 41.3 ± 20.7 months after diagnosis. Among the 32 patients without serous PED at diagnosis, PED developed in 20 (62.5%) at a mean of 10.9 ± 5.1 months after diagnosis. PED development was noted within 12 months in 15 patients (46.8%; 75.0% among the PED development cases). In 52 patients with serous PED and without SRF at diagnosis, 15 developed SRF (28.8%) at a mean of 11.2 ± 6.4 months after diagnosis. SRF development was noted within 12 months in nine patients (17.3%; 66.6% among the SRF development cases).
PED and SRF developed in a substantial proportion of patients with type 3 macular neovascularization. The average period of development of these pathologic findings was within 12 months of diagnosis, suggesting the need for active treatment during the early treatment period to improve treatment outcomes.
评估 3 型黄斑新生血管病变中色素上皮脱离(PED)和视网膜下液(SRF)的发生和发展时间。
本回顾性研究纳入了 84 例未经治疗的 3 型黄斑新生血管病变患者,这些患者在诊断时均未出现 SRF。所有患者均接受雷珠单抗或阿柏西普初始三联负荷剂量注射治疗。初始负荷剂量注射后,按需进行治疗。确定 PED 或 SRF 的发展情况。评估无 PED 患者中 PED 的发生情况和有 PED 患者中 SRF 的发生情况。
诊断后平均随访时间为 41.3±20.7 个月。在 32 例无浆液性 PED 的患者中,20 例(62.5%)在诊断后 10.9±5.1 个月时出现 PED。15 例(46.8%;PED 发生病例中 75.0%)在 12 个月内出现 PED。在 52 例有浆液性 PED 但无 SRF 的患者中,15 例(28.8%)在诊断后 11.2±6.4 个月时出现 SRF。9 例(17.3%;SRF 发生病例中 66.6%)在 12 个月内出现 SRF。
3 型黄斑新生血管病变患者中 PED 和 SRF 的发生率较高。这些病理性发现的平均发展时间在诊断后 12 个月内,这提示在早期治疗期间需要积极治疗,以改善治疗结局。