Rush Ryan B, Klein Westin, Rush Sloan W, Reinauer Robert M
Department of Ophthalmology, Panhandle Eye Group, Amarillo, TX, USA.
Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX, USA.
Clin Ophthalmol. 2024 Dec 27;18:4011-4018. doi: 10.2147/OPTH.S497678. eCollection 2024.
To evaluate real-world outcomes in subjects with pre-existing neovascular age-related macular degeneration (AMD) undergoing intravitreal avacincaptad pegol (IVA) treatment for geographic atrophy (GA).
This study was undertaken as a retrospective, case-controlled assessment of patients undergoing IVA treatment for GA from 2 community-based retina practices. Patients were separated into 1) a Study Group consisting of subjects with pre-existing neovascular AMD prior to initiation of IVA for GA, and 2) a Control Group consisting of AMD subjects without neovascularization prior to initiation of IVA for GA. Study and Control Group subjects had a baseline visual acuity of ≥ 20/200, a total GA lesion area of ≥ 1 mm and ≤ 17.5 mm, and follow-up of 12-months following IVA commencement.
A total of 64 patients were analyzed. No significant differences in baseline characteristics were found between cohorts. The Study Group had a greater decrease in visual acuity [-0.2 (-0.24 to -0.16) logMAR versus -0.04 (-0.06 to 0.02) logMAR; p<0.0001], a greater increase in GA lesion growth [1.36 (1.09-1.63) mm versus 0.52 (0.34-0.70) mm; p<0.0001], and a higher incidence of exudation (p=0.0002) compared to the Control Group during the study period.
This study suggests that patients undergoing IVA therapy for GA with pre-existing neovascular AMD have worse visual and anatomic outcomes at 12-months compared to a matched control group without pre-existing neovascularization; such patients therefore should be carefully counseled prior to initiation of IVA for the management of GA.
评估患有预先存在的新生血管性年龄相关性黄斑变性（AMD）的患者接受玻璃体内注射阿伐西普（IVA）治疗地理性萎缩（GA）的真实世界疗效。
本研究是一项对来自2个社区视网膜诊所接受IVA治疗GA的患者进行的回顾性病例对照评估。患者被分为1）研究组，由在开始针对GA进行IVA治疗之前患有预先存在的新生血管性AMD的受试者组成，以及2）对照组，由在开始针对GA进行IVA治疗之前没有新生血管形成的AMD受试者组成。研究组和对照组受试者的基线视力≥20/200，GA病变总面积≥1mm且≤17.5mm，并在开始IVA治疗后进行12个月的随访。
共分析了64例患者。队列之间在基线特征方面未发现显著差异。在研究期间，研究组的视力下降幅度更大[-0.2（-0.24至-0.16）logMAR，而对照组为-0.04（-0.06至0.02）logMAR；p<0.0001]，GA病变生长增加幅度更大[1.36（1.09 - 1.63）mm，而对照组为0.52（0.34 - 0.70）mm；p<0.0001]，渗出发生率更高（p = 0.0002）。
本研究表明，与没有预先存在新生血管形成的匹配对照组相比，患有预先存在的新生血管性AMD并接受IVA治疗GA的患者在12个月时视力和解剖学结果更差；因此，在开始针对GA的IVA治疗之前，应仔细咨询此类患者。
