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抗血管内皮生长因子治疗后1型和2型近视性脉络膜新生血管的特征及治疗结果比较

Comparison of Characteristics and Treatment Outcomes of Type 1 and Type 2 Myopic Choroidal Neovascularization After Anti-Vascular Endothelial Growth Factor Therapy.

作者信息

Tew Teck Boon, Hsieh Yi-Ting, Tsui Mei-Chi, Hsia Yun, Lee Cheng-Yung, Wang Shih-Wen, Huang Chien-Jung, Ma I-Hsin, Hung Kuo-Chi, Lai Tso-Ting, Yang Chang-Hao, Yang Chung-May, Ho Tzyy-Chang

机构信息

Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Department of Ophthalmology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.

出版信息

Retina. 2025 Jul 14. doi: 10.1097/IAE.0000000000004611.

Abstract

PURPOSE

This study aims to compare baseline characteristics and treatment outcomes of type 1 and type 2 myopic choroidal neovascularization (CNV) after one year of anti-vascular endothelial growth factors (VEGF) therapy and identify clinical factors associated with visual outcomes, recurrence rates, and injection numbers.

METHODS

In this retrospective study, we reviewed 171 patients with active mCNV treated with anti-VEGF therapy and followed for at least one year. CNV types were classified using optical coherence tomography (OCT). Baseline characteristics, including best-corrected visual acuity (BCVA), myopic maculopathy grade, and OCT findings, were compared.

RESULTS

Type 1 CNVs (19.3% of cases) exhibited worse baseline BCVA and more advanced macular degeneration than type 2 CNVs. Both types showed significant visual improvement equivalent to 2.2 lines post-therapy, with no difference in recurrence rates or injection numbers. Multivariate analysis revealed that baseline BCVA, severity of myopic macular degeneration, and presence of subretinal hyperreflective exudation were significant predictors of final BCVA, while CNV type was not an independent predictor.

CONCLUSION

Despite more severe macular degeneration in type 1 CNV, both types myopic CNVs benefit significantly from anti-VEGF therapy. These findings support extending treatment to type 1 CNVs and highlight the need for individualized management strategies.

摘要

目的

本研究旨在比较抗血管内皮生长因子(VEGF)治疗一年后1型和2型近视性脉络膜新生血管(CNV)的基线特征和治疗结果,并确定与视力结果、复发率和注射次数相关的临床因素。

方法

在这项回顾性研究中,我们回顾了171例接受抗VEGF治疗且随访至少一年的活动性近视性CNV患者。使用光学相干断层扫描(OCT)对CNV类型进行分类。比较了包括最佳矫正视力(BCVA)、近视性黄斑病变分级和OCT检查结果在内的基线特征。

结果

1型CNV(占病例的19.3%)在基线时的BCVA较差,黄斑变性比2型CNV更严重。两种类型在治疗后均显示出相当于2.2行的显著视力改善,复发率和注射次数无差异。多变量分析显示,基线BCVA、近视性黄斑变性的严重程度和视网膜下高反射性渗出物的存在是最终BCVA的显著预测因素,而CNV类型不是独立的预测因素。

结论

尽管1型CNV的黄斑变性更严重,但两种类型的近视性CNV均从抗VEGF治疗中显著获益。这些发现支持将治疗扩展至1型CNV,并强调了个性化管理策略的必要性。

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