Purpose There are limited real-world data on long-term mortality and visual outcomes in patients treated with anti-vascular endothelial growth factor (VEGF) for exudative age-related macular degeneration (exudative AMD). We assessed 10-year mortality and clinical outcomes in exudative AMD patients treated with intravitreal therapy (IVT) anti-VEGF injections on a pro-re-nata (PRN) regime following a standard loading regime. Methods Retrospective cohort study of the first 216 exudative AMD patients receiving IVT anti-VEGF for exudative AMD at a public tertiary referral hospital in Scotland. Main outcome measures were mortality, cause of death and best-corrected visual acuity (BCVA). Results A total of 216 patients were included. Mean age at presentation was 79.1 years [standard deviation (SD) 6.9]. Mean follow-up duration was 6.6 years (SD 3.2) during which there was a mean 24.3 Early Treatment Diabetic Retinopathy Study (ETDRS) letter loss in BCVA (P < 0.0001). Patients received a mean of 2.2 (SD 1.8) injections per year of follow-up. Overall, 52.6% (113/216) died during the period studied. Observed annual mortality incidence risk was 6.5% (SD 3.1) and was found to be significantly lower (P = 0.0064) than the expected annual death incidence risk (9.6%, SD 1.5) based on age and sex standardised Scottish mortality risk. The most common causes of death were malignancies (21.3%) and infection (20.0%). Conclusions This study highlights the relatively good long-term prognosis in vision and mortality in exudative AMD treated with a PRN regime in the real world. Although the majority lost vision, the rate of decline was significantly slower than that which would have been experienced in the pre-anti-VEGF era and reassuringly standardised mortality risk was lower than the national average.

中文翻译：

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玻璃体内注射抗血管内皮生长因子治疗渗出性年龄相关性黄斑变性患者的 10 年死亡率和长期视力结果

目的 关于使用抗血管内皮生长因子 (VEGF) 治疗渗出性年龄相关性黄斑变性（渗出性 AMD）的患者的长期死亡率和视力结果的真实数据有限。我们评估了渗出性 AMD 患者的 10 年死亡率和临床结果，这些患者在标准负荷方案后在 pro-re-nata (PRN) 方案中接受玻璃体内治疗 (IVT) 抗 VEGF 注射治疗。方法对在苏格兰一家公立三级转诊医院接受 IVT 抗 VEGF 治疗渗出性 AMD 的首批 216 名渗出性 AMD 患者进行回顾性队列研究。主要结局指标是死亡率、死因和最佳矫正视力（BCVA）。结果共纳入216例患者。就诊时的平均年龄为 79.1 岁 [标准差 (SD) 6.9]。平均随访时间为 6.6 年（SD 3. 2) 在此期间，BCVA 有平均 24.3 早期治疗糖尿病视网膜病变研究 (ETDRS) 字母丢失 (P < 0.0001)。患者每年接受平均 2.2 (SD 1.8) 次随访。总体而言，52.6% (113/216) 在研究期间死亡。观察到的年死亡率风险为 6.5% (SD 3.1)，并且发现显着低于 (P = 0.0064) 基于年龄和性别标准化苏格兰死亡率风险的预期年死亡率风险 (9.6%, SD 1.5)。最常见的死亡原因是恶性肿瘤（21.3%）和感染（20.0%）。结论 本研究强调了在现实世界中使用 PRN 方案治疗的渗出性 AMD 在视力和死亡率方面相对良好的长期预后。尽管大多数人失去了视力，