Abstract
Objective
To evaluate the effect of anti-vascular endothelial growth factor (VEGF) on juxtafoveal choroidal neovascularization (CNV) secondary to multifocal choroiditis (MFC) and wet age-related macular degeneration (AMD). Methods: In this retrospective, comparative study, 20 unique eyes with CNV were divided into two groups: 10 patients affected by MFC and 10 patients diagnosed with wet AMD. They all received local intravitreal (IVT) injections of ranibizumab, with 6 months of follow-up. Retreatment injections were performed based on findings suggestive of active neovascularization.
Results
Significant improvements were observed in the juxtafoveal CNV lesions, and average central macular thickness decreased in both groups following the anti-VEGF therapy (P<0.05). The average number of injections used in MFC patients was 1.6, while three injections on average were used in wet AMD patients (Z=−2.844, P=0.009). Best-corrected visual acuity was significantly improved in MFC patients after anti-VEGF therapy (P<0.05), and there was no significant difference in wet AMD patients between before anti-VEGF therapy and 6 months later (P>0.05).
Conclusions
IVT ranibizumab resulted in good clinical outcomes for juxtafoveal CNV secondary to MFC and wet AMD, but the average number of injections used in MFC was fewer than that used in wet AMD over a 6-month observation period. Compared with the wet AMD group, visual acuity was obviously improved in the MFC group at 6 months.
概 要
目 的
比较抗血管内皮生长因子 (VEGF) 药物对多灶性脉络膜炎 (MFC) 和湿性老年性黄斑变性 (AMD) 的疗效。
创新点
MFC 是一种特发性脉络膜视网膜病变, 容易并发多灶性脉络膜新生血管, 治疗棘手, 易复发。 目前有个别病例报道证明抗 VEGF 对其新生血管的治疗有效果, 但是缺少更多的数据比较。 本文将抗 VEGF 药物对 MFC 和 AMD 的疗效进行对比, 以了解其在不同疾病中的疗效。
方 法
收集 MFC 并发络膜新生血管和 AMD 并发络膜新生血管患者各 10 名, 予以玻璃体腔注射抗 VEGF 药物, 跟踪随访患者 6 个月的视力变化、 新生血管大小、 黄斑水肿情况。 随访期间采用眼底血管造影以及光学相干断层扫描进行监测, 如发现有活动性脉络膜新生血管, 予以再次注射。
结 论
抗 VEGF 药物对 MFC 并发的脉络膜新生血管有良好的治疗效果, 注射次数少于湿性 AMD 并发的新生血管治疗, 且视力恢复情况也较其明显。
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Project supported by the National Natural Science Foundation of China (No. 81500760)
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Feng, L., Hu, Jh., Chen, J. et al. An efficacy analysis of anti-vascular endothelial growth factor therapy for choroidal neovascularization secondary to multifocal choroiditis and comparison with wet age-related macular degeneration. J. Zhejiang Univ. Sci. B 19, 327–332 (2018). https://doi.org/10.1631/jzus.B1700535
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DOI: https://doi.org/10.1631/jzus.B1700535
Key words
- Wet age-related macular degeneration (AMD)
- Multifocal choroiditis (MFC)
- Juxtafoveal choroidal neovascularization (CNV)
- Anti-vascular endothelial growth factor (VEGF) therapy