Five-year visual acuity outcomes and injection patterns in patients with pro-re-nata treatments for AMD, DME, RVO and myopic CNV
Five-year visual acuity outcomes and injection patterns in patients with pro-re-nata treatments for AMD, DME, RVO and myopic CNV
复制标题
DOI：
10.1136/bjophthalmol-2016-308668
复制
发表时间：
2017-03-01
影响因子：
4.1
通讯作者：
Stahl, Andreas
中科院分区：
文献类型：
--
作者：
Wecker, Thomas;Ehlken, Christoph;Stahl, Andreas
抗血管内皮生长因子（VEGF）治疗是一种成熟的治疗视网膜疾病的方法。然而，关于注射频率和视力（VA）的长期数据仍然很少。方法对2072例慢性活动性疾病患者（2577只眼，33187次注射）的真实VA发展和注射模式进行了5年的分析，这些患者接受了年龄相关性黄斑变性（AMD）、糖尿病性黄斑水肿（DME）、视网膜静脉阻塞（RVO）和近视脉络膜新生血管（CNV）的术前治疗。结果AMD患者1年最大平均VA增益为+5.2个字母，DME患者为+6.2个字母，RVO患者为+10个字母，近视CNV患者为+7.2个字母。然而，5年后，AMD患者的VA下降。到第5年，34%的AMD患者经历了> - 15字母的VA损失，56%保持稳定，10%增加了> - 15字母。DME和RVO患者的长期VA发展更有利，DME患者的81%和RVO患者的79%在5年时获得或维持视力。在AMD患者中，第一年的中位注射频率为6次，连续4至5年。在DME和RVO中，第一年的中位注射频率为6次，但与AMD的连续年份相比较低。DME注射频率与患者年龄呈弱相关(r(s)=0.1；p = 0.03)。结论在AMD中，尽管与DME、RVO和近视CNV相比，注射次数较高，但初始VA增益不能长期维持。目前的真实数据提供了基于同伴群体的VA发展和注射频率的估计，用于咨询接受长期抗vegf治疗的患者。
Background Anti vascular endothelial growth factor (VEGF) therapy is an established treatment for various retinal diseases. Long-term data on injection frequencies and visual acuity (VA), however, are still rare.Methods Five-year analysis of real-life VA developments and injection patterns from 2072 patients (2577 eyes; 33187 injections) with chronically active disease undergoing pro-re-nata treatment for age-related macular degeneration (AMD), diabetic macular oedema (DME), retinal vein occlusion (RVO) and myopic choroidal neovascularisation (CNV).Results Maximum mean VA gain in year 1 was+5.2 letters in AMD, +6.2 in DME, +10 in RVO and+7.2 in myopic CNV. Over 5years, however, VA in patients with AMD declined. By year 5, 34% of patients with AMD had experienced VA loss of >15 letters, 56% had remained stable and 10% had gained >15 letters. Long-term VA developments in DME and RVO were more favourable with 81% of DME and 79% of patients with RVO gaining or maintaining vision at 5years. In AMD, median injection frequency was six in year 1 and between four and five in consecutive years. In DME and RVO, median injection frequency was six in year 1 but lower compared with AMD in consecutive years. Injection frequency in DME was weakly associated with patient age (r(s)=0.1; p=0.03).Conclusions In AMD, the initial VA gain was not maintained long term despite higher injection numbers compared with DME, RVO and myopic CNV. The presented real-world data provide a peer-group-based estimate of VA developments and injection frequencies for counselling patients undergoing long-term anti-VEGF therapy.