湿性老年性黄斑病变抗血管生成治疗效果的预测

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目的：揭示湿性老年性黄斑病变（AMD）患者玻璃体内注射阿伯西普治疗效果的预后因素。

材料和方法：该研究中纳入了36例（45只眼,26名女性和10名男性，平均年龄在74.4±10.9岁）先前治疗失败的湿性AMD患者。所有患者均接受了每月3次阿伯西普玻璃体注射以及之后再次注射4次（每次间隔为2个月）。评估了人口学特征、初始最佳矫正视力（BCVA）、中心视网膜厚度（CMT）和光学相干断层扫描（OCT）的结构变化，以判断在10个月的随访中与BCVA的相关性。

结果：在观察期结束时，初始视力从31.0±15.0（~0.32）个字符增加到37.0±14.0（~0.4）个字符（p=0.003）。治疗开始时和随访结束时的CMT分别为357±110和269±70μm（p<0.001）。最终BCVA与初始视力（r=0.62；p<0.0001）、初始CMT（r=-0.48；p=0.001）以及从症状出现到开始治疗的时长（r=-0.32；p=0.03）在统计学上有显著相关性。OCT图像上黄斑结构的变化与最终BCVA无关，除了椭圆体带状态（p<0.001）。男性的最终BCVA在统计学上明显低于女性（分别为34.7±14.0（~0.4）和45.0±9.2（~0.63）个字符，p=0.03）。

结论：初始视力、性别、CMT、从发病到开始治疗的时长和椭圆体带状态是湿性AMD患者抗血管生成治疗效果的预测因素。

作者简介

Alexandr Kharakozov

S.M.Kirov Military medical academy

编辑信件的主要联系方式.
Email: kharakozoff@mail.ru
ORCID iD: 0000-0003-4598-0826
SPIN 代码: 1208-5237

Graduated. S.M. Kirov Military Medical Academy

俄罗斯联邦, 194044, St. Petersburg, st. Academician Lebedev, 6

Alexey Kulikov

S.M.Kirov Military medical academy

Email: alexey.kulikov@mail.ru
ORCID iD: 0000-0002-5274-6993

MD, PhD, DSc, Assistant Professor, Head of the Ophthalmology Department. S.M. Kirov Military Medical Academy

俄罗斯联邦, 194044, St. Petersburg, st. Academician Lebedev, 6

Dmitrii Maltsev

S.M. Kirov Military Medical Academy

Email: glaz.med@yandex.ru
ORCID iD: 0000-0001-6598-3982

MD, PhD, Head of Medical Retina Division of Ophthalmology Department. S.M. Kirov Military Medical Academy

俄罗斯联邦, 194044, St. Petersburg, st. Academician Lebedev, 6

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2. Fig. 1. Representative examples of the status of the ellipsoid zone evaluation: а — complete preservation of the ellipsoid zone; b — disruption of the ellipsoid zone (arrows)

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3. Fig. 2. Representative examples of structural retinal changes on optical coherence tomography scans: а — subretinal hyperreflective material (arrow); b — intraretinal hyperreflective material (arrow) and subretinal fluid; c — a combination of different kinds of hyperreflective material (intra- and subretinal hyperreflective material), and intraretinal fluid (arrow)

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4. Fig. 3. Scattering plots showing correlation of final best-corrected visual acuity (BCVA) with baseline BCVA (a), and with baseline central retinal thickness (СRT) (b)

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