Multicentre study of 4626 patients assesses the effectiveness, safety and burden of two categories of treatments for central retinal vein occlusion: intravitreal anti-vascular endothelial growth factor injections and intravitreal Ozurdex injections.
Multicentre study of 4626 patients assesses the effectiveness, safety and burden of two categories of treatments for central retinal vein occlusion: intravitreal anti-vascular endothelial growth factor injections and intravitreal Ozurdex injections.
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DOI：
10.1136/bjophthalmol-2020-317306
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
UK EMR Database Users Group
中科院分区：
文献类型：
--
作者：
Gale R;Gill C;Pikoula M;Lee AY;Hanson RLW;Denaxas S;Egan C;Tufail A;Taylor P;UK EMR Database Users Group
评估视网膜中央静脉阻塞（CRVO）两种治疗方法的有效性、负担和安全性：玻璃体内注射抗血管内皮生长因子（抗VEGF）和地塞米松（Ozurdex）。对英国27家NHS研究中心的Medisoft电子病历（EPR）数据进行的回顾性分析确定了4619例接受单一治疗模式的CRVO继发性黄斑水肿初治患者。生成了描述总体CRVO患者队列和按治疗类型分层的个体患者亚群的统计数据。报告了基线时的平均年龄、性别、种族、社会剥夺和视力（VA）随访。使用早期治疗糖尿病视网膜病变评分的VA绝对值和变化用于描述治疗有效性，注射次数和访视次数用于描述治疗负担和眼内炎发生率，作为治疗安全性的标志。抗VEGF组和Ozurdex组的平均VA分别为47.9和45.3 EDTRS字母。对于单独抗VEGF组，这在12个月时变为57.9 / 53.7，在18个月时变为58.3 / 46.9，在36个月时变为59.4。对于单独抗VEGF组，12个月时的平均注射次数为5.6 / 1.6，18个月时为6.0 / 1.7，36个月时为7.3。抗VEGF组的眼内炎发生率为0.003%（n = 4），地塞米松组为0.09%（n = 1）。抗VEGF治疗的VA改善更大且更持久。较低的起始视力导致两组患者获得更大的收益，而较高的起始视力导致36个月时的VA较高。尽管抗VEGF治疗负担更大，但Ozurdex与眼内炎发生率更高相关。
To assess the effectiveness, burden and safety of two categories of treatment for central retinal vein occlusion (CRVO): intravitreal injections of anti-Vascular Endothelial Growth Factor (anti-VEGF) and Dexamethasone (Ozurdex). A retrospective analysis of Medisoft Electronic Patient Record (EPR) data from 27 NHS sites in the UK identified 4619 treatment naive patients with a single mode of treatment for macular oedema secondary to CRVO. Statistics describing the overall CRVO patient cohort and individual patient sub-populations stratified by treatment type were generated. Mean age at baseline, gender, ethnicity, social deprivation and visual acuity (VA) follow-up was reported. Absolute and change in VA using Early Treatment Diabetic Retinopathy Score are used to describe treatment effectiveness, the number of injections and visits used to describe treatment burden and endophthalmitis rates as a marker of treatment safety. Mean VA was 47.9 and 45.3 EDTRS letters in the anti-VEGF and Ozurdex groups, respectively. This changed to 57.9 / 53.7 at 12-months, 58.3 / 46.9 at 18-months and 59.4 at 36-months for the anti-VEGF group alone. Mean number of injections were 5.6 / 1.6 at 12-months, 6.0 / 1.7 at 18-months, and 7.3 at 36-months for the anti-VEGF group alone. Endophthalmitis rates were 0.003% (n = 4) for the anti-VEGF group and 0.09% (n = 1) for the dexamethasone group. VA improvements were greater and more sustained with anti-VEGF treatment. Lower starting acuity resulted in bigger gains in both groups, whilst higher starting acuity resulted in higher VA at 36-months. Although treatment burden was greater with anti-VEGF, Ozurdex was associated with higher rates of endophthalmitis.
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