Foveal Thickness Fluctuation in Anti-VEGF Treatment for Branch Retinal Vein Occlusion: A Long-term Study
Foveal Thickness Fluctuation in Anti-VEGF Treatment for Branch Retinal Vein Occlusion: A Long-term Study
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DOI：
10.1016/j.oret.2022.02.008
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发表时间：
2022-07-06
影响因子：
4.5
通讯作者：
Tsujikawa, Akitaka
中科院分区：
文献类型：
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作者：
Nagasato, Daisuke;Muraoka, Yuki;Tsujikawa, Akitaka
目的：视网膜分支静脉阻塞（BRVO）导致黄斑水肿（ME），可以通过抗 VEGF 治疗来控制。然而，这些治疗并不能治愈，复发时需要额外的抗 VEGF 治疗。长期结果、最佳抗 VEGF 治疗方案以及 ME 复发的综合效应在很大程度上尚不清楚。因此，我们的目的是检查中心凹厚度 (FT) 波动 (FTF) 对通过 pro re nata 方案施用的 BRVO-ME 抗 VEGF 治疗的视觉和形态学结果的影响。设计：回顾性、观察性案例系列。受试者：本研究分析了 2012 年至 2021 年间在多中心视网膜诊所接受 BRVO-ME 治疗的 309 名初治患者（309 只眼）。方法：在每次研究访视时使用 OCT 评估 FT。主要结果指标：我们使用 OCT 评估了最小分辨率角 (logMAR) 最佳矫正视力 (BCVA) 的对数和黄斑中心凹椭球区 (EZ) 带的缺损长度。结果：基线时，平均 logMAR BCVA 为 0.30 +/- 0.30，平均 FT 为 503 +/- 162 mm。在平均随访期间（50.6 +/- 22.2 个月），BRVO-ME 的抗 VEGF 注射次数为 5.8 +/- 4.6 次。最终检查时，平均 logMAR BCVA 和 FT 值与基线相比显着改善。多元回归分析显示，年龄、基线 logMAR BCVA 和 FTF 与最终 logMAR BCVA 显着相关（分别为 b = 0.20、0.35 和 0.30）。中心凹厚度波动（按 FTF 升序分为 0-3 组）与 logMAR BCVA 和最终检查时中心凹 EZ 带的缺损长度显着相关。第 0 组和第 1 组的中心凹 EZ 带缺损长度纵向缩短，第 2 组和第 3 组略有延长。logMAR BCVA 显示第 0 组和第 1 组有所改善，第 2 组和第 3 组略有恶化。结论：中心凹厚度波动与视力和中心凹感光器状态显着相关。因此，通过识别具有较大 FTF 的眼睛的特征并因此更严格地控制 FTF，可以改善 BRVO 眼睛的形态和功能预后。美国眼科学会《眼科视网膜 2022；6:567-574 (c) 2022》。这是一篇遵循 CC BY-NC-ND 许可证 (http://creativecommons.org/licenses/by-nc-nd/4.0/) 的开放获取文章。
Purpose: Branch retinal vein occlusion (BRVO) causes macular edema (ME), which can be controlled with anti-VEGF treatments. However, these treatments are not curative, necessitating additional anti-VEGF treatments at recurrence. Long-term results, optimal anti-VEGF treatment regimens, and the comprehensive effects of ME recurrence are largely unknown. Thus, we aimed to examine the effects of foveal thickness (FT) fluctuation (FTF) on the visual and morphologic outcomes of anti-VEGF treatments for BRVO-ME administered via a pro re nata regimen. Design: A retrospective, observational case series. Subjects: This study analyzed 309 treatment-naive patients (309 eyes) with BRVO-ME between 2012 and 2021 at a multicenter retinal practice. Methods: The FT was assessed using OCT at each study visit. Main Outcome Measures: We evaluated the logarithm of the minimal angle of resolution (logMAR) best corrected visual acuity (BCVA) and the defect length of the foveal ellipsoid zone (EZ) band using OCT. Results: At baseline, the mean logMAR BCVA was 0.30 +/- 0.30 and the mean FT was 503 +/- 162 mm. The number of anti-VEGF injections for BRVO-ME was 5.8 +/- 4.6 during the mean follow-up period (50.6 +/- 22.2 months). At the final examination, the mean logMAR BCVA and FT values were significantly improved compared with those at the baseline. Multiple regression analyses showed that age, baseline logMAR BCVA, and FTF were significantly associated with the final logMAR BCVA (b = 0.20, 0.35, and 0.30, respectively). Foveal thickness fluctuation (divided into groups 0-3 in ascending order of FTF) was significantly associated with logMAR BCVA and the defect length of the foveal EZ band at the final examination. The defect lengths of the foveal EZ band were longitudinally shortened in groups 0 and 1 and were slightly prolonged in groups 2 and 3. The logMAR BCVA showed improvements in groups 0 and 1 and worsened slightly in groups 2 and 3. Conclusions: Foveal thickness fluctuation was significantly associated with visual acuity and foveal photoreceptor status. Thus, the morphologic and functional prognoses of eyes with BRVO may improve with the identification of the characteristics of eyes with greater FTF and consequently controlling the FTF more strictly. Ophthalmology Retina 2022;6:567-574 (c) 2022 by the American Academy of Ophthalmology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).