Zusammenfassung
Hintergrund
Das Ziel war es, eventuelle prognostische und prädiktive funktionelle oder morphologische Charakteristika für individuelle Visusergebnisse unter Anti-VEGF-Therapie bei exsudativer AMD zu definieren.
Patienten/Methode
Bei 128 Patienten dieser Gruppe wurden das bestkorrigierte Sehvermögen, die makuläre Netzhautsensitivität, die Netzhautdicke im OCT und Autofluoreszenzmuster (AF) erhoben.
Ergebnisse
Augen mit einem schlechten Ausgangsvisus und klassische CNV erzielten den größten Visusgewinn, während Augen mit einem initial guten Visus diesen primär stabilisierten. Es bestand keine Korrelation zur initialen Netzhautdicke, jedoch war eine veränderte AF mit einem ausbleibenden Visusgewinn assoziiert.
Schlussfolgerung
Bei geringer Aussagekraft der übrigen Parameter kam der foveolären AF eine größere Bedeutung als prädiktiver Faktor zu. Initiale Schäden im Bereich des retinalen Pigmentepithels und der Netzhaut können für einen ausbleibenden Visusgewinn ursächlich sein.
Abstract
Background
The aim of the study was to evaluate possible prognostic and predictive factors (morphologic and functional) of the individual visual gain/decline after anti-VEGF therapy of exudative AMD.
Patients/methods
Best corrected visual acuity (VA), microperimetric sensitivity (RS), retinal thickness (RT) and autofluorescence pattern (AF) were documented in128 patients with exudative AMD.
Results
Eyes with classic choroidal neovascularization (CNV) had the best visual gain but still remained at a lower level. Eyes which initially had the lowest VA had the largest gain and those with good initial VA could maintain this level. There was no correlation between RT and visual outcome. Eyes with initially normal AF had a significantly greater visual gain.
Conclusions
The type of CNV, initial VA, RS and the initial RT were only of limited usefulness, while the initial foveal AF was most important predictive factor. This may indicate that preexisting changes and irreversible damage in the outer retina and/or retinal pigment epithelium are responsible for the resulting VA after therapy.
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Heimes, B., Lommatzsch, A., Zeimer, M. et al. Anti-VEGF-Therapie der exsudativen AMD. Ophthalmologe 108, 124–131 (2011). https://doi.org/10.1007/s00347-010-2210-z
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DOI: https://doi.org/10.1007/s00347-010-2210-z