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在使用自动液体监测进行现实世界管理期间新生血管性年龄相关性黄斑变性的复发动态和模式

Dynamics and patterns of recurrence in neovascular AMD during real-world management using automated fluid monitoring.

作者信息

Prenner Veronika, Schmidt-Erfurth Ursula, Fuchs Philipp, Leingang Oliver, Coulibaly Leonard Mana, Bogunovic Hrvoje, Barthelmes Daniel, Reiter Gregor Sebastian

机构信息

Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.

Laboratory for Ophthalmic Image Analysis, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.

出版信息

Heliyon. 2024 May 18;10(10):e31567. doi: 10.1016/j.heliyon.2024.e31567. eCollection 2024 May 30.

Abstract

In this retrospective longitudinal observational study, data from one site of the Fight Retinal Blindness! Registry (University of Zurich, Switzerland) was used to investigate the quantity and distribution of recurrent fluid in neovascular age-related macular degeneration (nAMD). Study eye eligibility required treatment-naïve nAMD, receiving at least three anti-vascular endothelial growth factor injections, followed by a treatment discontinuation of at least six months and subsequence fluid recurrence. To quantify fluid, a regulatory approved deep learning algorithm (Vienna Fluid Monitor, RetInSight, Vienna, Austria) was used. Fifty-six eyes of 56 patients with a mean age of 76.29 ± 6.58 years at baseline fulfilled the inclusion criteria. From baseline to the end of the first treatment-free interval, SRF volume had decreased significantly (58.0 nl (IQR 10-257 nl) to 8.73 nl (IQR 1-100 nl), p < 0.01). The quantitative increase in IRF volume from baseline to the end of the first treatment-free interval was not statistically significant (1.35 nl (IQR 0-107 nl) to 5.18 nl (IQR 0-24 nl), p = 0.13). PED also did not reach statistical significance (p = 0.71). At the end of the second treatment discontinuation there was quantitatively more IRF (17.3 nl) than SRF (3.74 nl). In conclusion, discontinuation of treatment with anti-VEGF therapy may change the fluid pattern in nAMD.

摘要

在这项回顾性纵向观察研究中,使用了“抗击视网膜失明!注册研究”(瑞士苏黎世大学)一个站点的数据,以调查新生血管性年龄相关性黄斑变性(nAMD)中反复出现的积液的数量和分布情况。研究眼的纳入标准为未经治疗的nAMD,接受至少三次抗血管内皮生长因子注射,随后至少停药六个月且出现积液复发。为了量化积液,使用了一种经监管部门批准的深度学习算法(维也纳积液监测仪,RetInSight,奥地利维也纳)。56例患者的56只眼在基线时的平均年龄为76.29±6.58岁,符合纳入标准。从基线到第一个无治疗间隔期结束时,视网膜下液(SRF)体积显著减少(从58.0 nl(四分位间距10 - 257 nl)降至8.73 nl(四分位间距1 - 100 nl),p < 0.01)。从基线到第一个无治疗间隔期结束时,视网膜内液(IRF)体积的定量增加无统计学意义(从1.35 nl(四分位间距0 - 107 nl)增至5.18 nl(四分位间距0 - 24 nl),p = 0.13)。色素上皮脱离(PED)也未达到统计学意义(p = 0.71)。在第二次停药结束时,IRF的量(17.3 nl)比SRF(3.74 nl)更多。总之,停止抗VEGF治疗可能会改变nAMD中的积液模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c14/11141345/04b396b814e0/gr1.jpg

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