The Effects of Treatment Regimen on the Initial Management of Macular Neovascularization Subtypes in Age-Related Macular Degeneration.

IF 2.1 4区医学 Q2 OPHTHALMOLOGY Ophthalmologica Pub Date : 2023-01-01 DOI:10.1159/000529409

Kenny Kodaday, Laurent Kodjikian, Etienne Gadiollet, Nicolas Chirpaz, Olivier Loria, Audrey Feldman, Flore De Bats, Carole Burillon, Philippe Denis, Pierre Pradat, Thibaud Mathis

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引用次数: 1

Abstract

Introduction: The aim of this study was to evaluate the effect of initial treatment regimen individualization (pro re nata or treat-and-extend [TAE]), according to macular neovascularization (MNV) subtype, on the functional and anatomical response in neovascular age-related macular degeneration (nAMD). The secondary objective was to compare the treatment burden between each MNV subtype.

Methods: Consecutive treatment-naïve nAMD patients were retrospectively included. MNV subtype was graded by 2 independent blinded investigators on multimodal imaging. Functional and anatomical outcomes were analysed according to treatment regimen and MNV subtypes.

Results: A total of 281 eyes from 243 patients were included in the study. According to the treatment regimen, there was no significant difference in best-corrected visual acuity gain within the first 2 years of treatment for type 1 (p = 0.106) and type 3 MNV (p = 0.704). Conversely, there was a significant difference in favour of TAE regimen for type 2 (p = 0.017) and type 4 MNV (p = 0.047). Type 1 MNV had a higher proportion of visits with subretinal fluid (p = 0.0007) but not with intraretinal fluid (p = 0.22). The mean interval between the last 2 injections was significantly shorter for type 1 MNV (p = 0.0045).

Conclusion: The individualization of the initial treatment protocol according to MNV subtype can improve the functional outcome and may decrease the treatment burden.

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治疗方案对老年性黄斑变性黄斑新生血管亚型初始管理的影响。

本研究的目的是根据黄斑新生血管(MNV)亚型评估初始治疗方案个体化(再生或治疗扩展[TAE])对新生血管性年龄相关性黄斑变性(nAMD)的功能和解剖学反应的影响。次要目的是比较每个MNV亚型之间的治疗负担。方法:回顾性纳入连续treatment-naïve nAMD患者。MNV亚型由2名独立的盲法研究者通过多模态成像进行分级。根据治疗方案和MNV亚型分析功能和解剖结果。结果:243例患者共281只眼纳入研究。根据治疗方案，1型MNV和3型MNV治疗前2年内最佳矫正视力增加无显著差异(p = 0.106) (p = 0.704)。相反，对于2型MNV (p = 0.017)和4型MNV (p = 0.047)，支持TAE方案的差异有统计学意义。1型MNV患者视网膜下积液的就诊比例较高(p = 0.0007)，而视网膜内积液的就诊比例较低(p = 0.22)。1型MNV最后2次注射的平均间隔明显缩短(p = 0.0045)。结论:根据MNV亚型个性化初始治疗方案可改善功能结局，减轻治疗负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmologica 医学-眼科学

CiteScore

5.10

自引率

3.80%

发文量

审稿时长

3 months

期刊介绍： Published since 1899, ''Ophthalmologica'' has become a frequently cited guide to international work in clinical and experimental ophthalmology. It contains a selection of patient-oriented contributions covering the etiology of eye diseases, diagnostic techniques, and advances in medical and surgical treatment. Straightforward, factual reporting provides both interesting and useful reading. In addition to original papers, ''Ophthalmologica'' features regularly timely reviews in an effort to keep the reader well informed and updated. The large international circulation of this journal reflects its importance.