Moshfeghi Andrew A, Pitcher John D, Lucas Genevieve, Boucher Nick, Saroj Namrata
Department of Ophthalmology, Keck School of Medicine, Roski Eye Institute, University of Southern California, Los Angeles, CA, USA.
Eye Associates of New Mexico, Albuquerque, NM, USA.
J Vitreoretin Dis. 2020 Oct 27;5(3):221-226. doi: 10.1177/2474126420960896. eCollection 2021 May-Jun.
This work evaluates dosing frequency with intravitreal antivascular endothelial growth factor (anti-VEGF) agents over 2 years and visual acuity (VA) outcomes in neovascular age-related macular degeneration (nAMD).
This retrospective analysis assesses electronic medical record data (Vestrum Health treatment and outcomes database) of newly diagnosed nAMD in patients who were initiated on intravitreal anti-VEGF treatment at US clinical sites. Eyes were divided into 2 injection frequency subcohorts (≤ 6 or > 6 injections/y); treatment frequency and change in mean VA (Early Treatment Diabetic Retinopathy Study letters) were evaluated.
Overall, 8127 of 213 824 eyes met inclusion criteria in year 1 and 4968 in year 2. During year 1, 77% of the eyes received more than 6 injections (n = 6287), the majority of which received injections at the same frequency during year 2. Mean VA gain from baseline at year 1 was lower in the ≤ 6 than > 6 injections/y subcohort (2.2 vs 6.5, < .001). Decrease in mean VA from the end of year 1 to year 2 was significantly greater for eyes administered 6 or fewer injections in year 2 than those that received more frequent injections, irrespective of the frequency of injections in the first year.
In routine clinical practice, most eyes with nAMD that completed at least 1 year of follow-up were treated with more than 6 injections of anti-VEGF agents during the first year of treatment, resulting in better VA gains than eyes treated less frequently during the same period.
本研究评估了2年内玻璃体内注射抗血管内皮生长因子（anti-VEGF）药物的给药频率以及新生血管性年龄相关性黄斑变性（nAMD）患者的视力（VA）转归。
这项回顾性分析评估了美国临床机构中开始接受玻璃体内抗VEGF治疗的新诊断nAMD患者的电子病历数据（Vestrum Health治疗与转归数据库）。将患眼分为2个注射频率亚组（每年≤6次或>6次注射）；评估治疗频率和平均视力（早期糖尿病性视网膜病变研究字母表）变化。
总体而言，213824只眼中有8127只在第1年符合纳入标准，第2年有4968只。在第1年，77%的患眼接受了超过6次注射（n = 6287），其中大多数在第2年以相同频率接受注射。每年≤6次注射亚组在第1年时相对于基线的平均视力提高低于每年>6次注射亚组（2.2对6.5，P<0.001）。从第1年末到第2年，第2年接受6次或更少注射的患眼平均视力下降幅度显著大于接受更频繁注射的患眼，这与第1年的注射频率无关。
在常规临床实践中，大多数完成至少1年随访的nAMD患眼在治疗的第1年接受了超过6次抗VEGF药物注射，与同期接受较少频率治疗的患眼相比，视力提高更好。
