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Morphological characteristics of eyes with neovascular age-related macular degeneration and good long-term visual outcomes after anti-VEGF therapy
British Journal of Ophthalmology ( IF 3.7 ) Pub Date : 2023-03-01 , DOI: 10.1136/bjophthalmol-2021-319602
Mengyuan Fang 1, 2 , Karntida Chanwimol 2 , Jyotsna Maram 2 , Ghazala A Datoo O'Keefe 3 , Charles C Wykoff 4, 5 , David Sarraf 6 , A'sha Brown 3 , Shaun Ian Retief Lampen 4, 5 , Brenda Zhou 4, 5 , Alexander M Rusakevich 4, 5 , SriniVas Sadda 6, 7
Affiliation  

Purpose To analyse the morphological characteristics of eyes with neovascular age-related macular degeneration (AMD) with good long-term visual acuity after anti-VEGF (vascular endothelial growth factor) therapy. Methods Retrospective, observational study of 175 patients with neovascular AMD with >5 years of follow-up after initiating anti-VEGF therapy. Spectral-domain optical coherence tomography images were assessed for thickness of pigment epithelial detachment (PED), subretinal hyper-reflective material (SHRM), subretinal fluid and subfoveal choroidal, as well as the integrity of the outer retinal bands. Results The final analysis cohort included 203 eyes (175 patients) followed for a mean of 7.84±1.70 years (range: 5–11). The maximum PED thickness in the foveal central subfield (FCS) was significantly lower (p<0.001) in the poor vision group (13.11 μm) compared with the intermediate (86.25 μm) or good (97.92 μm) vision groups, respectively. In contrast, the maximum thickness of SHRM in the FCS was significantly thicker (p<0.001) in eyes with poor vision (149.46 μm) compared with eyes with intermediate vision (64.37 μm) which in turn were significantly thicker (p<0.001) than eyes with good vision (9.35 μm). The good vision group also had better continuity of all outer retinal bands (external limiting membrane, ellipsoid zone, and retinal pigment epithelium) compared with the other two groups (all p<0.001). Conclusion A thicker PED and thinner SHRM were correlated with better vision in eyes with neovascular AMD following long-term anti-VEGF therapy. If replicated in future prospective studies, these findings may have implications for design of optimal anatomic endpoints for neovascular AMD treatment. All data relevant to the study are included in the article or uploaded as online supplemental information. There is no additional information available.

中文翻译:

抗血管内皮生长因子治疗后新生血管性年龄相关性黄斑变性眼的形态学特征及良好的远期视力结果

目的分析抗VEGF(血管内皮生长因子)治疗后远期视力良好的新生血管性年龄相关性黄斑变性(AMD)眼的形态特征。方法 对 175 名新生血管性 AMD 患者进行回顾性观察研究,在开始抗 VEGF 治疗后进行了超过 5 年的随访。评估了光谱域光学相干断层扫描图像的色素上皮脱离 (PED)、视网膜下超反射材料 (SHRM)、视网膜下液和中心凹下脉络膜的厚度,以及外视网膜带的完整性。结果 最终分析队列包括 203 只眼(175 名患者),平均随访时间为 7.84±1.70 年(范围:5-11)。中心凹中央子区域 (FCS) 的最大 PED 厚度显着降低 (p<0. 001) 在较差视力组 (13.11 μm) 中分别与中等 (86.25 μm) 或良好 (97.92 μm) 视力组进行比较。相比之下,视力较差的眼睛 (149.46 μm) 中 FCS 中 SHRM 的最大厚度明显较厚 (p<0.001),而中等视力的眼睛 (64.37 μm) 又明显较厚 (p<0.001)视力良好的眼睛(9.35 微米)。与其他两组相比,良好视力组的所有外视网膜带(外界膜、椭圆体区和视网膜色素上皮)的连续性也更好(所有 p < 0.001)。结论 较厚的 PED 和较薄的 SHRM 与长期抗 VEGF 治疗后新生血管性 AMD 眼的更好视力相关。如果在未来的前瞻性研究中重复,这些发现可能对设计新生血管性 AMD 治疗的最佳解剖终点有影响。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。没有可用的附加信息。
更新日期:2023-02-20
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