眼睛的损伤区域进展与新血管与年龄相关的黄斑变性,使用主动或反应性疗法治疗
Mariano Cozzi1, Davide Monteduro1, Raffaele Antonio Esposito1
1Eye Clinic, Department of Biomedical and Clinical Science, University of Milan, Milan, Italy.
Eye (London, England)
|July 1, 2023
概括
一个主动的抗血管内皮生长因子 (VEGF) 治疗新血管与年龄相关的黄斑变性 (nAMD) 的方案导致病变缩小和四年来更好的视力. 反应性策略导致病变扩张和更糟糕的结果.
科学领域:
- 眼科医生 眼科 眼科
- 视网膜疾病 视网膜疾病
- 医疗成像医学成像
背景情况:
- 神经血管与年龄相关的黄斑变性 (nAMD) 是导致视力丧失的主要原因.
- 抗血管内皮生长因子 (VEGF) 药物是对nAMD的标准治疗.
- 治疗策略各不相同,包括主动和反应性疗法.
研究的目的:
- 用抗VEGF药物治疗的nAMD眼睛4年内病变区域的变化进行比较.
- 在常规临床实践中评估主动与反应性治疗方案的疗效.
主要方法:
- 多中心,回顾性对比研究202个未经治疗的nAMD眼睛.
- 患者接受了至少4年的积极性 (n=105) 或反应性 (n=97) 抗VEGF治疗.
- 从串行光学连贯断层扫描 (OCT) 图像中划分的损伤边缘,以计算生长率.
主要成果:
- 积极组:平均损伤面积显著比基线减少 (在4年内从7.24毫米2减少到5.16毫米2,p<0.001).
- 反应组:平均损伤面积从基线显著扩大 (在4年内从6.33mm2扩大到9.24mm2,p<0.001).
- 治疗方案,基线面积和活跃病变比例影响了4年病变面积.
结论:
- 对nAMD的反动抗VEGF策略导致病变面积增加,并在4年后视觉结果恶化.
- 积极的治疗方案与较少的复发,病变缩和视力改善有关.
- 积极的治疗似乎更有效地管理nAMD病变的进展.
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