GEOGRAPHIC ATROPHY INCIDENCE AND PROGRESSION AFTER INTRAVITREAL INJECTIONS OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR AGENTS FOR AGE-RELATED MACULAR DEGENERATION A Meta-Analysis
GEOGRAPHIC ATROPHY INCIDENCE AND PROGRESSION AFTER INTRAVITREAL INJECTIONS OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR AGENTS FOR AGE-RELATED MACULAR DEGENERATION A Meta-Analysis
复制标题
DOI：
10.1097/iae.0000000000003207
复制
发表时间：
2021-12-01
影响因子：
3.3
通讯作者：
Kertes, Peter J.
中科院分区：
文献类型：
--
作者：
Eshtiaghi, Arshia;Issa, Mariam;Kertes, Peter J.
目的：地理萎缩（GA）是晚期新生血管性年龄相关性黄斑变性的并发症，可导致永久性视力丧失。我们试图评估患有新生血管性年龄相关性黄斑变性的眼睛玻璃体内注射抗血管内皮生长因子药物后 GA 的发生率和进展。方法：检索了 Ovid MEDLINE、EMBASE 和 Cochrane CENTRAL，检索范围从建库到 2020 年 5 月。纳入的研究报告了新生血管性年龄相关性黄斑变性眼在接受抗血管内皮生长因子治疗后 GA 的进展或发展。结果：纳入 31 篇文章和 4,609 只研究眼（4,501 名患者）。 35.2 个月内，眼睛平均接受 17.7 次注射。基线时 GA 患病率为 9.7%。随访结束时 GA 的汇总发生率为 30.5%。最终随访时，平均注射总数与 GA 发生率之间存在正、中度线性相关（R-2 = 0.30；P = 0.01）。与妊娠前相比，每月治疗与 GA 发生的风险显着较高相关（相对风险 = 1.40，95% 置信区间 = [1.21-1.61]，P < 0.001）。 GA 发生的危险因素包括对侧眼 GA、视网膜血管瘤增殖、玻璃膜疣和网状假性玻璃膜疣。结论：我们发现抗血管内皮生长因子药物治疗的频率和次数与新生血管性年龄相关性黄斑变性中 GA 的发生有关。未来的研究应阐明风险因素、人群特征以及治疗和疾病进展对 GA 发展的相对贡献。
Purpose: Geographic atrophy (GA) is a complication of advanced neovascular age-related macular degeneration that can lead to permanent vision loss. We sought to estimate the incidence and progression of GA after intravitreal injections of antivascular endothelial growth factor agents in eyes with neovascular age-related macular degeneration. Methods: Ovid MEDLINE, EMBASE, and Cochrane CENTRAL were searched from inception to May 2020. Included studies reported on the progression or development of GA in eyes with neovascular age-related macular degeneration after antivascular endothelial growth factor therapy. Results: Thirty-one articles and 4,609 study eyes (4,501 patients) were included. Eyes received a mean of 17.7 injections over 35.2 months. The prevalence of GA at baseline was 9.7%. The pooled incidence of GA was 30.5% at the end of follow-up. There was a positive, moderate linear correlation between the mean total number of injections and GA incidence at the final follow-up (R-2 = 0.30; P = 0.01). Monthly treatment was associated with a significantly higher risk for GA development relative to pro re nata (relative risk = 1.40, 95% confidence interval = [1.21-1.61], P < 0.001). Risk factors for GA development included GA in the fellow eye, retinal angiomatous proliferation, drusen, and reticular pseudodrusen. Conclusion: We found an association between the frequency and number of treatments with antivascular endothelial growth factor agents and the development of GA in neovascular age-related macular degeneration. Future studies should clarify risk factors, population characteristics, and relative contributions of treatment and disease progression on GA development in this context.