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抗VEGF注射治疗新生血管性年龄相关性黄斑变性时神经节细胞层厚度的变化

Ganglion Cell Layer Thickness Change in Neovascular Age-Related Macular Degeneration Treated With Anti-VEGF Injections.

作者信息

Mantopoulos Dimosthenis, Ray Hetal, Sanchez George, Pokroy Russell, Roth Daniel B

机构信息

Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

Geisel School of Medicine at Dartmouth, Hanover, NH, USA.

出版信息

J Vitreoretin Dis. 2021 Sep 16;6(2):126-131. doi: 10.1177/24741264211040346. eCollection 2022 Mar-Apr.

Abstract

PURPOSE

This work assesses bilateral ganglion cell layer-inner plexiform layer (GCL-IPL) thickness changes in patients with unilateral neovascular age-related macular degeneration (nAMD) treated with antivascular endothelial growth factor (anti-VEGF).

METHODS

In this single-center, retrospective, cohort study, the medical records of patients with unilateral nAMD treated with anti-VEGF were reviewed. The treated group included eyes with newly diagnosed nAMD that subsequently underwent treatment with intravitreal anti-VEGF injections. The control group was the fellow eye with dry AMD. Eyes receiving at least 10 intravitreal injections were included. Measurement of GCL-IPL thickness was performed at different time points using spectral domain-optical coherence tomography.

RESULTS

A total of 216 eyes of 108 patients met the inclusion criteria. The mean age ± SD was 80.1 ± 10.7 years. Eyes in the treated group underwent a mean ± SD of 20.2 ± 7.2 injections in 21.3 ± 6.8 months. At baseline, average mean ± SD of GCL-IPL thickness was 73.71 ± 8.81 µm and 73.84 ± 8.26 µm in the treated and fellow eye, respectively ( = .795). After 10 injections the average thickness was 65.41 ± 14.08 µm and 68.77 ± 13.24 µm in the treated and fellow eye, respectively ( = .007). The absolute decrease in thickness was significantly greater in the treated eye than the fellow eye (mean ± SD, 8.31 ± 11.19 µm vs 5.07 ± 10.83 µm, respectively; = .002).

CONCLUSIONS

GCL-IPL thickness decreased significantly in the treated group more than in the control group after 10 anti-VEGF injections. The mechanism and clinical significance of this observation warrants further study.

摘要

目的

本研究评估接受抗血管内皮生长因子(anti-VEGF)治疗的单侧新生血管性年龄相关性黄斑变性(nAMD)患者双侧神经节细胞层-内丛状层(GCL-IPL)厚度的变化。

方法

在这项单中心、回顾性队列研究中,对接受anti-VEGF治疗的单侧nAMD患者的病历进行了回顾。治疗组包括新诊断为nAMD且随后接受玻璃体内anti-VEGF注射治疗的患眼。对照组为对侧干性AMD眼。纳入至少接受10次玻璃体内注射的患眼。使用频域光学相干断层扫描在不同时间点测量GCL-IPL厚度。

结果

108例患者的216只患眼符合纳入标准。平均年龄±标准差为80.1±10.7岁。治疗组患眼在21.3±6.8个月内平均接受了20.2±7.2次注射。基线时,治疗组患眼和对侧眼GCL-IPL厚度的平均±标准差分别为73.71±8.81µm和73.84±8.26µm(P = 0.795)。10次注射后,治疗组患眼和对侧眼的平均厚度分别为65.41±14.08µm和68.77±13.24µm(P = 0.007)。治疗组患眼厚度的绝对减少明显大于对侧眼(平均±标准差分别为8.31±11.19µm和5.07±10.83µm;P = 0.002)。

结论

10次anti-VEGF注射后,治疗组GCL-IPL厚度的下降明显大于对照组。这一观察结果的机制和临床意义值得进一步研究。

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