Abe Maiko, Kunikata Hiroshi, Aizawa Naoko, Yasuda Masayuki, Nitta Fumihiko, Abe Toshiaki, Nakazawa Toru
Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan.
Int J Retina Vitreous. 2025 Feb 10;11(1):16. doi: 10.1186/s40942-025-00632-1.
To investigate the association between oxidative stress (OS) and both the risk of neovascular age-related macular degeneration (nAMD) and the treatment response to intravitreal anti-vascular endothelial growth factor injections (anti-VEGF IVIs).
This retrospective study included 46 treatment-naïve nAMD eyes of 46 patients (26 male and 20 female) who received anti-VEGF IVIs with a "treat-and-extend" regimen following an initial loading phase for one year. The patients were divided into two groups according to the total number of anti-VEGF IVIs administered during the year: the "effective" group and the "resistant" group. OS was evaluated by diacron reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP), and skin autofluorescence (SAF) at baseline. For comparison, 54 control subjects were recruited.
There were no significant differences in d-ROM or BAP levels between control subjects and nAMD patients, regardless of sex, whereas SAF levels were higher in nAMD patients overall and in male nAMD patients than in controls (P < 0.001 for both). The effective and resistant groups included 30 and 16 eyes, respectively. Among the male nAMD patients, the effective and resistant groups had similar baseline characteristics, including age, smoking history, visual acuity, and central macular thickness; however, the resistant group had higher SAF levels (effective vs. resistant: 2.3 vs. 2.6 arbitrary units [AU]; P = 0.02). This finding was further supported by a multiple logistic regression analysis, which showed that the odds ratio for SAF was 1.57 per 0.1 AU increase (P = 0.01).
SAF levels were significantly higher in nAMD patients than in controls. The total number of anti-VEGF IVIs required over one year in male nAMD patients depended on SAF levels, suggesting that the SAF levels may serve as a potential biomarker for the response to anti-VEGF IVIs in nAMD.
研究氧化应激（OS）与新生血管性年龄相关性黄斑变性（nAMD）风险以及玻璃体内抗血管内皮生长因子注射（抗VEGF IVIs）治疗反应之间的关联。
这项回顾性研究纳入了46例患者（26例男性和20例女性）的46只初治nAMD眼，这些患者在初始负荷期一年后接受了“治疗并延长”方案的抗VEGF IVIs治疗。根据一年中给予抗VEGF IVIs的总数将患者分为两组：“有效”组和“抵抗”组。在基线时通过二乙酰反应性氧代谢产物（d-ROMs）、生物抗氧化潜能（BAP）和皮肤自发荧光（SAF）评估OS。为作比较，招募了54名对照受试者。
无论性别如何，对照受试者与nAMD患者之间的d-ROM或BAP水平均无显著差异，而nAMD患者总体以及男性nAMD患者的SAF水平高于对照组（两者均P < 0.001）。有效组和抵抗组分别包括30只眼和16只眼。在男性nAMD患者中，有效组和抵抗组具有相似的基线特征，包括年龄、吸烟史、视力和中心黄斑厚度；然而，抵抗组的SAF水平更高（有效组与抵抗组：2.3对2.6任意单位[AU]；P = 0.02）。多元逻辑回归分析进一步支持了这一发现，该分析表明SAF每增加0.1 AU的优势比为1.57（P = 0.01）。
nAMD患者的SAF水平显著高于对照组。男性nAMD患者一年中所需抗VEGF IVIs的总数取决于SAF水平，这表明SAF水平可能作为nAMD中抗VEGF IVIs反应的潜在生物标志物。
