Background To describe 10-year trends in visual outcomes, anatomical outcomes and treatment burden of patients receiving antivascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD). Methods Retrospective cohort study of treatment-naïve, first-affected eyes with nAMD started on ranibizumab before January 1, 2009. The primary outcome was time to best-corrected visual acuity (BCVA) falling ≤35 ETDRS letters after initiating anti-VEGF therapy. Secondary outcomes included time to BCVA reaching ≥70 letters, proportion of eyes with BCVA ≥70 and ≤35 letters in 10 years, mean trend of BCVA and central retinal thickness over 10 years, and mean number of injections. Results For our cohort of 103 patients, Kaplan-Meier analyses demonstrated median time to BCVA reaching ≤35 and ≥70 letters were 37.8 (95% CI 22.2 to 65.1) and 8.3 (95% CI 4.8 to 20.9) months after commencing anti-VEGF therapy, respectively. At the final follow-up, BCVA was ≤35 letters and ≥70 letters in 41.1% and 21%, respectively, in first-affected eyes, while this was the case for 5.4% and 48.2%, respectively, in a patient’s better-seeing eye. Mean injection number was 37.0±24.2 per eye and 53.6±30.1 at patient level (63.1% of patients required injections in both eyes). Conclusions The chronicity of nAMD disease and its management highlights the importance of long-term visual prognosis. Our analyses suggest that one in five patients will retain good vision (BCVA ≥70 ETDRS letters) in the first-affected eye at 10 years after starting anti-VEGF treatment; yet, one in two patients will have good vision in their better-seeing eye. Moreover, our data suggest that early treatment of nAMD is associated with better visual outcomes.

中文翻译：

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新生血管性年龄相关性黄斑变性的十年生存趋势

背景 描述接受抗血管内皮生长因子 (anti-VEGF) 治疗新生血管性年龄相关性黄斑变性 (nAMD) 患者的视觉结果、解剖结果和治疗负担的 10 年趋势。方法 2009 年 1 月 1 日之前，对未接受过治疗、首发 nAMD 患眼的回顾性队列研究开始使用雷珠单抗。主要结果是开始抗 VEGF 治疗后最佳矫正视力 (BCVA) 下降 ≤ 35 ETDRS 字母的时间。次要结果包括 BCVA 达到 ≥70 个字母的时间、10 年内 BCVA ≥70 且≤35 个字母的眼睛比例、10 年内 BCVA 和中央视网膜厚度的平均趋势以及平均注射次数。结果 对于我们的 103 名患者队列，Kaplan-Meier 分析显示 BCVA 达到 ≤35 和 ≥70 个字母的中位时间为 37。分别在开始抗 VEGF 治疗后 8 个月（95% CI 22.2 至 65.1）和 8.3 个月（95% CI 4.8 至 20.9）。在最后一次随访中，41.1% 和 21% 的首发患眼 BCVA ≤35 个字母和≥70 个字母，而在患者较好的情况下分别为 5.4% 和 48.2%。看见眼睛。平均注射次数为每只眼 37.0±24.2 次，患者水平为 53.6±30.1 次（63.1% 的患者需要双眼注射）。结论 nAMD 疾病的慢性化及其管理凸显了长期视力预后的重要性。我们的分析表明，在开始抗 VEGF 治疗 10 年后，五分之一的患者将在首发患眼中保持良好的视力（BCVA ≥70 ETDRS 字母）；然而，二分之一的患者在他们的视力较好的眼睛中会有良好的视力。而且，