Anti-vascular endothelial growth factor therapy in diabetic macular edema: real-life outcomes from a multicenter study in Turkey over 36 months
Anti-vascular endothelial growth factor therapy in diabetic macular edema: real-life outcomes from a multicenter study in Turkey over 36 months
复制标题
抗血管内皮生长因子治疗糖尿病性黄斑水肿：土耳其一项为期 36 个月的多中心研究的现实结果
DOI：
10.1007/s10792-022-02375-6
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发表时间：
2022
影响因子：
1.6
通讯作者：
E. S. Yılmaz
中科院分区：
文献类型：
--
作者：
A. Durukan;N. Unlu;M. Onen;M. Alp;Y. S. Yeşiltaş;D. Kalaycı;M. A. Acar;M. Şekeroğlu;M. Çıtırık;A. Altıntaş;Dicle Hazırolan;M. Kucukevcilioglu;P. Ozdal;Yasin Toklu;Tolga Bicer;N. Uğurlu;Ozlem Budakoglu;Z. Yazar;N. Ucgun;Kurtuluş Serdar;Sibel Doğuizi;Yasemin Ozdamar Erol;C. U. Atılgan;M. A. Yorgun;D. Soba;N. Berker;C. Baskan;E. S. Yılmaz
本研究旨在报告土耳其真实临床环境中36个月内玻璃体内抗VEGF治疗糖尿病黄斑水肿（DME）的视觉和解剖结局。这是一项回顾性、多中心（7个中心）研究。审查了2007年4月至2017年2月期间接受玻璃体内抗VEGF注射治疗的706例因涉及中心的DME导致视力受损的连续患者的1072只眼（既往接受过治疗的眼和未接受过治疗的眼）的病历。根据随访持续时间（12、24或36个月），将患眼分为相互排斥的三组。主要结果指标是每个队列中从基线到最终访视的视力（VA）和中央黄斑厚度（CMT）的变化、访视频率和玻璃体内抗VEGF注射。作为次要终点，在按基线VA [<70 ETDRS字母和≥70 ETDRS字母]和抗VEGF注射的负荷剂量状态分层的亚组中评估VA结局。最终访视时，VA平均增加8.2个字母（12个月队列，p < 0.001）、5.3个字母（24个月队列，p < 0.001）和4.4个字母（36个月队列，p = 0.017）。视力字母70的眼<70 VA letters achieved more significant VA improvement at final visits in all cohorts compared with eyes with >（P < 0.001）。从基线至12个月、24个月和36个月队列末次访视时CMT的平均降低分别为−100.5 µm、−107.7 µm和−114.3 µm（p < 0.001）。在第1 - 3年期间，平均注射次数分别为4.6、2.3和1.8。在所有随访队列中，接受负荷剂量的患者显示出比未接受负荷剂量的患者更大的VA增益。我们的研究显示，抗VEGF治疗在36个月的随访中改善了VA和CMT。尽管这些抗VEGF治疗DME后的真实VA结局与其他真实研究相似，但它们劣于随机对照试验中观察到的结果，主要是由于治疗不足。
This study aimed to report the visual and anatomical outcomes of intravitreal anti-VEGF treatment for diabetic macular edema (DME) in a real-world clinical setting from Turkey over 36 months. This is a retrospective, multicenter (7 sites) study. The medical records of 1072 eyes (both previously treated and naive eyes) of 706 consecutive patients with visual impairment due to center-involving DME treated with intravitreal anti-VEGF injections between April 2007 and February 2017 were reviewed. The eyes were divided into mutually exclusive three groups based on the duration of follow-up (12, 24, or 36 months). Primary outcome measures were changes in visual acuity (VA) and central macular thickness (CMT) from baseline to final visit in each cohort, frequency of visits and intravitreal anti-VEGF injections. As secondary endpoints, VA outcomes were assessed in subgroups stratified by baseline VA [<70 ETDRS letters and ≥70 ETDRS letters] and loading dose status of anti-VEGF injections. VA increased by a mean of 8.2 letters (12-month cohort, p < 0.001), 5.3 letters (24-month cohort, p < 0.001), and 4.4 letters (36-month cohort, p = 0.017) at final visits. The eyes with <70 VA letters achieved more significant VA improvement at final visits in all cohorts compared with eyes with >70 VA letters (p < 0.001). The mean decreases in CMT from baseline to last visits at 12-, 24-, and 36- month cohorts were −100.5 µm, −107.7 µm, and −114.3 µm, respectively (p < 0.001). The mean number of injections given were 4.6, 2.3, and 1.8 during years 1 to 3, respectively. Patients who received loading dose showed greater VA gains than those who did not in all follow-up cohorts. Our study revealed that anti-VEGF treatment improved VA and CMT over a follow-up of 36 months. Although these real-life VA outcomes following anti-VEGF therapy for DME were similar to other real-life studies, they were inferior to those noted in randomized controlled trials, mainly due to undertreatment.
影响因子：
13.7
作者：
Nguyen, Quan Dong;Shah, Syed Mahmood;Campochiaro, Peter A.
通讯作者：
Campochiaro, Peter A.