Manchester Royal Eye Hospital and Manchester Academic Health Sciences Centre, Manchester University NHS Foundation Trust Manchester, Manchester, M13 9WL, UK.
Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
Graefes Arch Clin Exp Ophthalmol. 2024 Aug;262(8):2411-2419. doi: 10.1007/s00417-024-06429-6. Epub 2024 Mar 6.
Adjunctive treatment or longer-acting drugs are required to treat nAMD to help ease burdens for patients and hospital clinics alike. Stereotactic therapy is one such option, providing a reduction in the number of injections over time.
To determine the clinical outcomes in a cohort of patients with nAMD receiving a combination therapy of stereotactic radiotherapy (SRT) with intravitreal anti-VEGF injections (IVI).
A retrospective analysis of 74 patients with nAMD, who had received IVI and SRT (16 Gray maximum dose to the macula) at a large tertiary university eye hospital, between March 2018 and September 2019 was performed. The number of IVIs, visual acuity (VA), and central retinal thickness (CRT) were evaluated at 12, 24, and 36 months after patients received SRT and compared to the same time interval prior to SRT.
Follow-up data at 12, 24, and 36 months following and prior to SRT was available for 74, 48, and 22 patients respectively. Overall there was a significant reduction in the number of injections post-SRT. Twelve months following SRT, the median number of IVI was reduced by 1 (p < 0.05). The reduction in the median number of IVI was significantly reduced by 3 and 6 injections at 24- and 36-month follow-up respectively (p < 0.05). The CRT was significantly reduced post-SRT compared to the baseline values at all time periods. There was no statistically significant difference in VA at 12-month follow-up compared to baseline. The VA, however, significantly decreased at 24- and 36-month follow-up (p < 0.05).
A therapy combining SRT with IVI has shown an overall reduction in the number of injections required in nAMD patients at 12, 24, and 36 months following SRT compared to IVI treatment alone. These real-world outcomes are comparable to other studies while also confirming the maintenance of the reduced frequency of required IVI for patients with nAMD.
为了帮助减轻患者和医院诊所的负担，需要对 nAMD 进行辅助治疗或使用作用时间更长的药物。立体定向治疗就是这样一种选择，它可以随着时间的推移减少注射次数。
确定接受立体定向放射治疗（SRT）联合玻璃体内抗血管内皮生长因子注射（IVI）治疗的 nAMD 患者队列的临床结果。
对 2018 年 3 月至 2019 年 9 月在一家大型三级大学眼科医院接受 IVI 和 SRT（黄斑最大剂量 16 格雷）治疗的 74 例 nAMD 患者进行回顾性分析。在接受 SRT 后 12、24 和 36 个月评估 IVI 次数、视力（VA）和中心视网膜厚度（CRT），并与 SRT 前的同一时间间隔进行比较。
SRT 后和 SRT 前 12、24 和 36 个月的随访数据分别可用于 74、48 和 22 例患者。总体而言，SRT 后注射次数明显减少。SRT 后 12 个月，IVI 中位数减少 1 次（p<0.05）。24 个月和 36 个月随访时，IVI 中位数分别减少 3 次和 6 次，差异有统计学意义（p<0.05）。SRT 后 CRT 与基线值相比明显降低，所有时间段均有统计学意义。SRT 后 12 个月随访时 VA 与基线相比无统计学差异。然而，24 个月和 36 个月随访时 VA 明显下降（p<0.05）。
与单独使用 IVI 治疗相比，SRT 联合 IVI 的治疗在 SRT 后 12、24 和 36 个月时 nAMD 患者所需注射次数总体减少。这些真实世界的结果与其他研究相似，同时也证实了 nAMD 患者所需 IVI 注射频率的降低得以维持。
