Schultheiss Maximilian, Haritoglou Christos, Boneva Stefaniya, Binder Susanne, Sebag Jerry
Augenklinik Herzog Carl Theodor, Nymphenburger Str. 43, 80335, München, Deutschland.
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Ophthalmologie. 2023 Oct;120(10):999-1003. doi: 10.1007/s00347-023-01940-3. Epub 2023 Oct 11.
Intravitreal anti-vascular endothelial growth factor (VEGF) is the standard treatment for exudative age-related macular degeneration (AMD). The constitution of the vitreomacular interface varies greatly in cases of attached (with or without traction) or detached vitreous body, which can impact the effectiveness of the anti-VEGF treatment.
Based on the current literature this article displays the current state of the science on whether the constitution of the vitreous body has an effect on the anti-VEGF treatment.
The published data extracted from current trials and post hoc analyses concerning this topic are presented and put into the clinical context.
The presence of a vitreomacular adhesion reduces the efficacy of anti-VEGF treatment of exudative AMD. Posterior vitreous body detachment represents a positive prognostic factor concerning the efficacy of anti-VEGF treatment but not necessarily the prognosis for visual acuity.
Patients with attached vitreous body need a more intensive treatment monitoring compared to patients with detached vitreous body. Therefore, in eyes with initial posterior vitreous body detachment receiving a treat and extend regimen, the interval between anti-VEGF injections can be extended to 4 instead of 2 weeks without endangering the success of treatment.
玻璃体内注射抗血管内皮生长因子（VEGF）是渗出性年龄相关性黄斑变性（AMD）的标准治疗方法。在玻璃体附着（有或无牵拉）或脱离的情况下，玻璃体黄斑界面的结构差异很大，这可能会影响抗VEGF治疗的效果。
基于当前文献，本文展示了玻璃体结构是否对抗VEGF治疗有影响这一科学领域的现状。
呈现从当前关于该主题的试验和事后分析中提取的已发表数据，并将其置于临床背景中。
玻璃体黄斑粘连的存在会降低抗VEGF治疗渗出性AMD的疗效。玻璃体后脱离是抗VEGF治疗疗效的一个积极预后因素，但不一定是视力预后的因素。
与玻璃体脱离的患者相比，玻璃体附着的患者需要更密切的治疗监测。因此，在接受治疗并延长方案的初始玻璃体后脱离的眼中，抗VEGF注射之间的间隔可以延长至4周而不是2周，而不会危及治疗的成功。
