Rush Ryan B, Klein Westin, Rush Sloan W, Reinauer Robert
Department of Ophthalmology, Panhandle Eye Group, Amarillo, TX, USA.
Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX, USA.
Clin Ophthalmol. 2025 Jan 9;19:111-118. doi: 10.2147/OPTH.S498985. eCollection 2025.
To assess the 12-month outcomes in subjects developing macular neovascularization (MNV) during intravitreal avacincaptad pegol (IVA) treatment for geographic atrophy (GA) secondary to age-related macular degeneration (AMD).
This research was conducted as a case-controlled, retrospective study of AMD subjects undergoing IVA treatment for GA from two private practice institutions. Subjects were divided into 1) a Study Group of patients who developed MNV and then underwent anti-vascular endothelial growth factor (VEGF) therapy during the study period, and 2) a Control Group of patients who were complication-free during the study period. Both cohorts had a baseline Snellen visual acuity of ≥ 20/200, a baseline GA total area of ≥ 1 mmand ≤ 17.5 mm, and 12 months of follow-up after initiation of IVA for GA.
There were 56 patients analyzed. There were no significant differences in baseline features between cohorts. The Study Group had a greater decrease in visual acuity [-0.22 logMAR (-0.27 to -0.17) versus -0.06 logMAR (-0.12 to 0.00); p=<0.0001], and greater GA total lesion growth [1.78 mm (1.53-2.03) versus 0.78 mm (0.54-1.02); p=<0.0001] during the 12-month study period compared to the Control Group.
Patients developing MNV while undergoing IVA treatment for GA secondary to AMD have worse clinical outcomes despite undergoing anti-VEGF therapy compared to patients who were complication-free at 12-months. This highlights the seriousness of MNV in this patient population and may help specialists counsel patients when considering treatment for GA secondary to AMD.
评估玻璃体内注射阿伐西普（IVA）治疗年龄相关性黄斑变性（AMD）继发地图样萎缩（GA）过程中发生黄斑新生血管（MNV）的受试者的12个月结局。
本研究为一项病例对照、回顾性研究，纳入了来自两家私人医疗机构接受IVA治疗GA的AMD受试者。受试者分为两组：1）研究组，在研究期间发生MNV并接受抗血管内皮生长因子（VEGF）治疗的患者；2）对照组，在研究期间无并发症的患者。两组患者的基线Snellen视力均≥20/200，基线GA总面积≥1mm且≤17.5mm，且在开始IVA治疗GA后随访12个月。
共分析了56例患者。两组患者的基线特征无显著差异。与对照组相比，研究组在12个月研究期间视力下降更明显[-0.22 logMAR（-0.27至-0.17）vs -0.06 logMAR（-0.12至0.00）；p<0.0001]，GA总病变生长更大[1.78mm（1.53 - 2.03）vs 0.78mm（0.54 - 1.02）；p<0.0001]。
与12个月时无并发症的患者相比，AMD继发GA接受IVA治疗时发生MNV的患者尽管接受了抗VEGF治疗，临床结局仍较差。这凸显了该患者群体中MNV的严重性，可能有助于专科医生在考虑治疗AMD继发GA的患者时为其提供咨询。
