Visual Acuity Outcomes after Anti-Vascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration Age-Related Eye Disease Study 2 Report Number 19
Visual Acuity Outcomes after Anti-Vascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration Age-Related Eye Disease Study 2 Report Number 19
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DOI：
10.1016/j.oret.2019.06.001
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发表时间：
2020-01-01
影响因子：
4.5
通讯作者：
Chew, Emily Y.
中科院分区：
文献类型：
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作者：
Keenan, Tiarnan D.;Vitale, Susan;Chew, Emily Y.
目的：分析抗血管内皮生长因子（VEGF）治疗新生血管性年龄相关性黄斑变性（AMD）后的最佳矫正视力（BCVA）结果。设计：对参加口服补充剂临床试验并在常规临床实践中接受抗VEGF治疗的参与者进行前瞻性队列研究。眼相关眼病研究2（AREDS 2）参与者（50-85岁），基线时眼睛符合AREDS 2入选标准（没有晚期AMD，BCVA >= 20/100，没有先前的抗VEGF注射），但在随访期间接受至少1次抗VEGF注射以治疗偶发的新生血管性AMD。参与者在基线和5年内的年度研究访视时接受屈光BCVA测试、检眼镜检查和立体彩色眼底照相。自我报告的抗VEGF注射（数量，日期和药物名称）收集在基线和年度研究访问期间，并在电话中每6 months.Main结果测量：主要结果的措施是平均折射BCVA和比例的眼睛BCVA为20/40或更好和20/200或更差。一个探索性的结果措施是自我报告的抗VEGF injection.Results的平均数：一千一百零五眼的986 AREDS 2参与者符合纳入标准，其中，977名参与者（99.1%）进行了至少1个治疗后访问。在首次注射后的首次和后续年度检查中，平均屈光度BCVA分别为68.0个字母（Snellen当量，20/40）、66.1个字母、64.7个字母、63.2个字母和61.5个字母（Snellen当量，20/60）。BCVA为20/ 40或更好的患眼比例分别为59.3%、55.1%、53.5%、50.6%和49.7%，BCVA为20/200或更差的患眼比例分别为5.5%、8.6%、9.4%、12.4%和14.4%。自我报告的每只眼抗VEGF注射的平均年次数分别为2.9、3.9、3.3、3.1和3.0。结论：在临床试验环境中获得了不应BCVA数据，但与正常临床实践中给予的抗VEGF治疗相关。随着随访时间的延长，视力结果缓慢下降：平均BCVA每年下降约1.5至2个字母。5年时，一半的眼睛达到了20/40或更好的BCVA，但大约六分之一的眼睛显示BCVA为20/200或更差。这些数据可能有助于评估抗VEGF治疗的长期效果。爱思唯尔公司出版我代表美国眼科学会
Purpose: To analyze best-corrected visual acuity (BCVA) outcomes after anti-vascular endothelial growth factor (VEGF) treatment for neovascular age-related macular degeneration (AMD).Design: Prospective cohort study of participants enrolled in a clinical trial of oral supplements and receiving anti-VEGF therapy in routine clinical practice.Participants: Age-Related Eye Disease Study 2 (AREDS2) participants (50-85 years of age) whose eyes met AREDS2 inclusion criteria at baseline (no late AMD, BCVA >= 20/100, no previous anti-VEGF injections) but received at least 1 anti-VEGF injection for incident neovascular AMD during follow-up.Methods: Participants underwent refracted BCVA testing, ophthalmoscopic examination, and stereoscopic color fundus photography at baseline and annual study visits over 5 years. Self-reports of anti-VEGF injections (numbers, dates, and names of drug) were collected at baseline and annual study visits and during telephone calls every 6 months.Main Outcome Measures: Primary outcome measures were mean refracted BCVA and proportions of eyes with BCVA of 20/40 or better and 20/200 or worse. An exploratory outcome measure was the mean number of self-reported anti-VEGF injections.Results: One thousand one hundred five eyes of 986 AREDS2 participants met the inclusion criteria; of these, 977 participants (99.1 %) underwent at least 1 posttreatment visit. At the first and subsequent annual examinations after the first injection, mean refracted BCVAs were 68.0 letters (Snellen equivalent, 20/40), 66.1 letters, 64.7 letters, 63.2 letters, and 61.5 letters (Snellen equivalent, 20/60). Proportions of eyes with BCVA of 20/ 40 or better were 59.3%, 55.1%, 53.5%, 50.6%, and 49.7%, and those with BCVA of 20/200 or worse were 5.5%, 8.6%, 9.4%, 12.4%, and 14.4%. Mean annual numbers of self-reported anti-VEGF injections per eye were 2.9, 3.9, 3.3, 3.1, and 3.0.Conclusions: Refracted BCVA data were obtained in a clinical trial environment but were related to anti-VEGF treatment administered in normal clinical practice. Visual outcomes declined slowly with increased follow-up time: mean BCVA decreased by approximately 1.5 to 2 letters per year. At 5 years, half of eyes achieved BCVA of 20/40 or better, but approximately one sixth showed BCVA of 20/200 or worse. These data may be useful in assessing the long-term effects of anti-VEGF therapy. Published by Elsevier Inc. on behalf of the American Academy of Ophthalmology