Ophthalmology, Hadassah Medical Center, Jerusalem, Israel.
Ophthalmology, Hadassah Medical Center, Jerusalem, Israel
BMJ Open Ophthalmol. 2022 Dec;7(1). doi: 10.1136/bmjophth-2022-001180.
To compare outcome between patients treated using a modified treat-and-extend (mT&E) protocol and patients treated using a conventional T&E protocol.
A retrospective cohort study of two groups of treatment-naïve neovascular age-related macular degeneration patients within a single centre were evaluated. One group treated using the conventional T&E protocol, with visual acuity, dilated fundus examination (DFE) and optical coherence tomography (OCT) performed at each visit. The second group treated using the mT&E protocol in which visual acuity and DFE were performed only every three visits. The main outcome measures were time spent per clinical visit, visual and anatomical outcomes measured for 36 months.
The T&E and mT&E groups included 135 eyes in 116 patients and 119 eyes in 94 patients, respectively, with similar baseline characteristics. At 36 months, the number of injections administered (7.9±2.9 vs 8.1±2.3 injections, respectively; p=0.55), the percentage of eyes that gained ≥15 Early Treatment for Diabetic Retinopathy Study (ETDRS) letters (23% vs 25.2%, respectively; p=0.39) and the percentage of eyes that lost ≥15 ETDRS letters (21.5% vs 17.7%; p=0.43, respectively) were similar between the T&E and mT&E groups. However, waiting and contact time were reduced during the OCT-only visits compared with the full visits, with an average of 41 min saved per patient encounter.
Both protocols yielded similar visual and anatomical outcomes. However, the mT&E protocol reduced the number of full visits, with considerably less time spent at the clinic.
比较使用改良的治疗-延伸（mT&E）方案和常规 T&E 方案治疗的患者的结局。
对单中心内的两组未经治疗的新生血管性年龄相关性黄斑变性患者进行回顾性队列研究。一组采用常规 T&E 方案治疗，每次就诊时均进行视力、散瞳眼底检查（DFE）和光学相干断层扫描（OCT）检查。第二组采用 mT&E 方案治疗，仅每三次就诊时进行视力和 DFE 检查。主要观察指标为每次临床就诊所花费的时间、36 个月时测量的视力和解剖学结果。
T&E 和 mT&E 组分别纳入 116 例患者的 135 只眼和 94 例患者的 119 只眼，两组患者的基线特征相似。36 个月时，注射次数（分别为 7.9±2.9 和 8.1±2.3 次；p=0.55）、视力提高≥15 个早期糖尿病视网膜病变治疗研究（ETDRS）字母的眼数（分别为 23%和 25.2%；p=0.39）以及视力下降≥15 个 ETDRS 字母的眼数（分别为 21.5%和 17.7%；p=0.43）在 T&E 和 mT&E 组之间相似。然而，与全访视相比，OCT 仅访视时的等待和接触时间减少，每位患者每次就诊可节省 41 分钟。
两种方案均获得了相似的视力和解剖学结果。然而，mT&E 方案减少了全访视的次数，在诊所有效减少了时间。
