Korva-Gurung Ida, Kubin Anna-Maria, Ohtonen Pasi, Hautala Nina
Research Unit of Clinical Medicine and Medical Research Center, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland.
Medical Research Center, PEDEGO Research Unit, Department of Ophthalmology, Oulu University Hospital and University of Oulu, 90029 Oulu, Finland.
Pharmaceuticals (Basel). 2023 Jun 26;16(7):927. doi: 10.3390/ph16070927.
Neovascular age-related macular degeneration (nAMD) leads to visual impairment if not treated promptly. Intravitreal anti-VEGF drugs have revolutionized nAMD treatment in the past two decades. We evaluated the visual outcomes of anti-VEGF treatment in nAMD. A real-life population-based cohort study. The data included parameters for age, sex, age at diagnosis, laterality, chronicity, symptoms, visual outcomes, lens status, and history of intravitreal injections. A total of 1088 eyes (827 patients) with nAMD were included. Visual acuity was stable or improved in 984 eyes (90%) after an average of 36 ± 25 months of follow-up. Bevacizumab was the first-line drug in 1083 (99.5%) eyes. Vision improved ≥15 ETDRS letters in 377 (35%), >5 ETDRS letters in 309 (28%), and was stable (±5 ETDRS letters) in 298 (27%) eyes after anti-VEGF treatment. The loss of 5 ≤ 15 ETDRS letters in 44 (4%) eyes and ≥15 ETDRS letters in 60 (6%) eyes was noted. At the diagnosis of nAMD, 110 out of 827 patients (13%) fulfilled the criteria for visual impairment, whereas 179 patients (22%) were visually impaired after the follow-up. Improvement or stabilization in vision was noted in 90% of the anti-VEGF-treated eyes with nAMD. In addition, anti-VEGF agents are crucial in diminishing nAMD-related visual impairment.
新生血管性年龄相关性黄斑变性（nAMD）若不及时治疗会导致视力损害。在过去二十年中，玻璃体内注射抗血管内皮生长因子（VEGF）药物彻底改变了nAMD的治疗方式。我们评估了抗VEGF治疗nAMD的视力预后。一项基于实际人群的队列研究。数据包括年龄、性别、诊断时年龄、病变侧别、病程、症状、视力预后、晶状体状态以及玻璃体内注射史等参数。共纳入1088只眼（827例患者）的nAMD病例。经过平均36±25个月的随访，984只眼（90%）的视力保持稳定或有所改善。1083只眼（99.5%）将贝伐单抗作为一线药物。抗VEGF治疗后，377只眼（35%）的视力提高≥15个早期糖尿病视网膜病变研究（ETDRS）字母，309只眼（28%）提高>5个ETDRS字母，298只眼（27%）视力稳定（±5个ETDRS字母）。44只眼（4%）视力下降5≤15个ETDRS字母，60只眼（6%）下降≥15个ETDRS字母。在nAMD诊断时，827例患者中有110例（13%）符合视力损害标准，而随访后有179例患者（22%）出现视力损害。90%接受抗VEGF治疗的nAMD患眼的视力得到改善或稳定。此外，抗VEGF药物在减轻nAMD相关视力损害方面至关重要。
