Sherif M, Derradji Y, Safi A, Mantel I
University Eye Hospital Jules-Gonin, Lausanne, Switzerland.
Eye (Lond). 2025 May 10. doi: 10.1038/s41433-025-03830-1.
BACKGROUND/OBJECTIVES: This study aimed to evaluate the long-term (7 years) outcome of visual acuity in patients with neovascular age-related macular degeneration (nAMD) treated with anti-vascular endothelial growth factor (VEGF) agents following the observe-and-plan regimen.
SUBJECTS/METHODS: A total of 195 eyes from 181 patients with nAMD (mean age 79.5 ± 6.9 years), with a mean follow-up duration of 66 ± 37 months, treated with intravitreal anti-VEGF (ranibizumab or aflibercept) were included in this retrospective study. The principles of the observe-and-plan regimen were followed, with follow-up exceeding 3 years in real-life settings. Data collected included visual acuity (VA), number of injections and visits, central retinal thickness, and any complications over 7 years from baseline.
The mean baseline VA was 63 ± 17 Early Treatment of Diabetic Retinopathy Study letters (Snellen equivalent 20/63), improving to 73 ± 14 at year 1. The initial visual gain was slightly reduced with a final mean VA of 70 ± 18 letters (Snellen equivalent 20/40) at year 7. The mean central macular thickness decreased significantly from 375 ± 129 at baseline to 276 ± 75 at year 1 and to 279 ± 87 at year 7. The mean annual number of injections decreased from 8.7 ± 3.2 in year 1 to 6.7 ± 3.7 in year 2 and to 5.5 ± 2.8 in year 7. The mean annual number of visits remained constant throughout, with 4.1 ± 1.3 visits in year 1 and 4.7 ± 1.7 in year 7.
The observe-and-plan regimen was very efficient for treating nAMD in real-life settings, reducing the clinical burden on the medical system and patients, with excellent functional and structural long-term results.
背景/目的：本研究旨在评估采用观察与计划方案，接受抗血管内皮生长因子（VEGF）药物治疗的新生血管性年龄相关性黄斑变性（nAMD）患者的长期（7年）视力预后。
受试者/方法：本回顾性研究纳入了181例nAMD患者（平均年龄79.5±6.9岁）的195只眼，平均随访时间为66±37个月，患者接受了玻璃体内抗VEGF（雷珠单抗或阿柏西普）治疗。遵循观察与计划方案的原则，在实际临床中随访时间超过3年。收集的数据包括视力（VA）、注射次数和就诊次数、中心视网膜厚度以及基线后7年内的任何并发症。
平均基线视力为63±17糖尿病视网膜病变早期治疗研究视力表字母（相当于Snellen视力20/63），1年后提高到73±14。最初的视力改善略有下降，7年后最终平均视力为70±18字母（相当于Snellen视力20/40）。平均中心黄斑厚度从基线时的375±129显著下降至1年后的276±75，并在7年后降至279±87。平均每年注射次数从第1年的8.7±3.2次降至第2年的6.7±3.7次，并在第7年降至5.5±2.8次。平均每年就诊次数在整个过程中保持不变，第1年为4.1±1.3次，第7年为4.7±1.7次。
观察与计划方案在实际临床中治疗nAMD非常有效，减轻了医疗系统和患者的临床负担，具有优异的长期功能和结构预后。
