视网膜中央厚度第一年的变化可预测新生血管性老年黄斑变性患者的法定失明。

IF 2 4区 医学 Q2 OPHTHALMOLOGY Ophthalmic Research Pub Date : 2023-01-01 Epub Date: 2022-11-25 DOI:10.1159/000528161
Yi Guo, Jinye Wu, Xueying Zheng, Chang Yin, Zhenyu Wu
{"title":"视网膜中央厚度第一年的变化可预测新生血管性老年黄斑变性患者的法定失明。","authors":"Yi Guo, Jinye Wu, Xueying Zheng, Chang Yin, Zhenyu Wu","doi":"10.1159/000528161","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Due to its progressive nature, early evaluation and timely prediction of legal blindness are important in patients with neovascular age-related macular degeneration (nAMD). We examined the association between early-stage variation in central retinal thickness (CRT) and long-term visual outcomes in patients with nAMD.</p><p><strong>Methods: </strong>We included 103 nAMD patients who were administered anti-vascular endothelial growth factor (anti-VEGF). Participants were considered qualified if they were (1) 50 years and older, (2) treatment-naïve, (3) received standard anti-VEGF treatment and had complete baseline information. We further excluded patients with less than 1-year follow-up data and those who experienced best corrected visual acuity ≤35. Early-stage variability in CRT was measured as the first-year coefficient of variability (CV) of CRT. Patients were then classified into the high-variability and low-variability groups according to the X-tile. A product-limit plot was used to demonstrate the differences and tested with the log-rank test. The association between first-year variability and visual outcomes was quantified using Cox regression models. Time-to-event primary endpoint was the overall visual preservation (OVP) rate, defined as the time from the first injection to legal blindness, i.e., best corrected visual acuity ≤35 Early Treatment Diabetic Retinopathy Study (ETDRS) letters.</p><p><strong>Results: </strong>A threshold of 20% of first-year CV in CRT was used to categorize 76 qualified patients into high variability (35, 46.1%) and low variability (41, 53.9%). The 5- and 10-year OVPs for patients with high versus low variability were 76% versus 48% and 59% versus 22%, respectively. High early-stage CRT variability showed a significantly higher risk of legal blindness. Even after adjusting for the demographic and clinical features, the variability remained significant (HR = 2.39, 95% CI: 1.20-4.78).</p><p><strong>Conclusion: </strong>First-year variability of CRT was predictive of long-term visual outcomes in patients with nAMD, and 20% of the variability could be used as a clinically convenient threshold to qualitatively classify patients into high- and low-variability groups. The current study is important for identifying high-risk populations and for long-term disease management.</p>","PeriodicalId":19662,"journal":{"name":"Ophthalmic Research","volume":" ","pages":"406-412"},"PeriodicalIF":2.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10015761/pdf/","citationCount":"1","resultStr":"{\"title\":\"The First-Year Variation in Central Retinal Thickness Predicts Legal Blindness in Patients with Neovascular Age-Related Macular Degeneration.\",\"authors\":\"Yi Guo, Jinye Wu, Xueying Zheng, Chang Yin, Zhenyu Wu\",\"doi\":\"10.1159/000528161\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Due to its progressive nature, early evaluation and timely prediction of legal blindness are important in patients with neovascular age-related macular degeneration (nAMD). We examined the association between early-stage variation in central retinal thickness (CRT) and long-term visual outcomes in patients with nAMD.</p><p><strong>Methods: </strong>We included 103 nAMD patients who were administered anti-vascular endothelial growth factor (anti-VEGF). Participants were considered qualified if they were (1) 50 years and older, (2) treatment-naïve, (3) received standard anti-VEGF treatment and had complete baseline information. We further excluded patients with less than 1-year follow-up data and those who experienced best corrected visual acuity ≤35. Early-stage variability in CRT was measured as the first-year coefficient of variability (CV) of CRT. Patients were then classified into the high-variability and low-variability groups according to the X-tile. A product-limit plot was used to demonstrate the differences and tested with the log-rank test. The association between first-year variability and visual outcomes was quantified using Cox regression models. Time-to-event primary endpoint was the overall visual preservation (OVP) rate, defined as the time from the first injection to legal blindness, i.e., best corrected visual acuity ≤35 Early Treatment Diabetic Retinopathy Study (ETDRS) letters.</p><p><strong>Results: </strong>A threshold of 20% of first-year CV in CRT was used to categorize 76 qualified patients into high variability (35, 46.1%) and low variability (41, 53.9%). The 5- and 10-year OVPs for patients with high versus low variability were 76% versus 48% and 59% versus 22%, respectively. High early-stage CRT variability showed a significantly higher risk of legal blindness. Even after adjusting for the demographic and clinical features, the variability remained significant (HR = 2.39, 95% CI: 1.20-4.78).</p><p><strong>Conclusion: </strong>First-year variability of CRT was predictive of long-term visual outcomes in patients with nAMD, and 20% of the variability could be used as a clinically convenient threshold to qualitatively classify patients into high- and low-variability groups. The current study is important for identifying high-risk populations and for long-term disease management.</p>\",\"PeriodicalId\":19662,\"journal\":{\"name\":\"Ophthalmic Research\",\"volume\":\" \",\"pages\":\"406-412\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10015761/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmic Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000528161\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/11/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000528161","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/11/25 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 1

摘要

导言:新生血管性老年性黄斑变性(nAMD)是一种渐进性疾病,因此早期评估和及时预测法定失明对于nAMD患者非常重要。我们研究了视网膜中央厚度(CRT)早期变化与 nAMD 患者长期视觉结果之间的关系:我们纳入了 103 名接受抗血管内皮生长因子(anti-VEGF)治疗的 nAMD 患者。符合以下条件的患者被视为合格患者:(1) 50 岁及以上;(2) 未接受过治疗;(3) 接受过标准抗血管内皮生长因子治疗且基线信息完整。我们进一步排除了随访数据不足 1 年的患者和最佳矫正视力≤35 的患者。CRT 的早期变异性以 CRT 的第一年变异系数 (CV) 来衡量。然后根据 X 分位数将患者分为高变异性组和低变异性组。使用限积图来显示差异,并进行对数秩检验。第一年变异性与视觉结果之间的关系采用 Cox 回归模型进行量化。从时间到事件的主要终点是总体视力保持率(OVP),定义为从首次注射到合法失明(即最佳矫正视力≤35个早期治疗糖尿病视网膜病变研究(ETDRS)字母)的时间:以 CRT 第一年变异率 20% 为临界值,将 76 名合格患者分为高变异率患者(35 人,46.1%)和低变异率患者(41 人,53.9%)。高变异性与低变异性患者的 5 年和 10 年 OVP 分别为 76% 对 48% 和 59% 对 22%。早期 CRT 变异性高的患者合法失明的风险明显更高。即使调整了人口统计学和临床特征,变异性仍然显著(HR = 2.39,95% CI:1.20-4.78):结论:CRT 的第一年变异性可预测 nAMD 患者的长期视觉结果,20% 的变异性可作为临床上方便的阈值,将患者定性地分为高变异性组和低变异性组。目前的研究对于识别高危人群和长期疾病管理非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

摘要图片

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
The First-Year Variation in Central Retinal Thickness Predicts Legal Blindness in Patients with Neovascular Age-Related Macular Degeneration.

Introduction: Due to its progressive nature, early evaluation and timely prediction of legal blindness are important in patients with neovascular age-related macular degeneration (nAMD). We examined the association between early-stage variation in central retinal thickness (CRT) and long-term visual outcomes in patients with nAMD.

Methods: We included 103 nAMD patients who were administered anti-vascular endothelial growth factor (anti-VEGF). Participants were considered qualified if they were (1) 50 years and older, (2) treatment-naïve, (3) received standard anti-VEGF treatment and had complete baseline information. We further excluded patients with less than 1-year follow-up data and those who experienced best corrected visual acuity ≤35. Early-stage variability in CRT was measured as the first-year coefficient of variability (CV) of CRT. Patients were then classified into the high-variability and low-variability groups according to the X-tile. A product-limit plot was used to demonstrate the differences and tested with the log-rank test. The association between first-year variability and visual outcomes was quantified using Cox regression models. Time-to-event primary endpoint was the overall visual preservation (OVP) rate, defined as the time from the first injection to legal blindness, i.e., best corrected visual acuity ≤35 Early Treatment Diabetic Retinopathy Study (ETDRS) letters.

Results: A threshold of 20% of first-year CV in CRT was used to categorize 76 qualified patients into high variability (35, 46.1%) and low variability (41, 53.9%). The 5- and 10-year OVPs for patients with high versus low variability were 76% versus 48% and 59% versus 22%, respectively. High early-stage CRT variability showed a significantly higher risk of legal blindness. Even after adjusting for the demographic and clinical features, the variability remained significant (HR = 2.39, 95% CI: 1.20-4.78).

Conclusion: First-year variability of CRT was predictive of long-term visual outcomes in patients with nAMD, and 20% of the variability could be used as a clinically convenient threshold to qualitatively classify patients into high- and low-variability groups. The current study is important for identifying high-risk populations and for long-term disease management.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Ophthalmic Research
Ophthalmic Research 医学-眼科学
CiteScore
3.80
自引率
4.80%
发文量
75
审稿时长
6-12 weeks
期刊介绍: ''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.
期刊最新文献
Patient Preferences with Anti-Vascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema: A Multinational Discrete Choice Experiment Study. Worldwide burden of retinoblastoma from 1990-2021. Anp32b-deficiency suppresses ocular development by repression of Pax6. Analysis of retinal and choroidal microvasculature in systemic sclerosis using optical coherence tomography angiography: A systematic review and meta-analysis. Longitudinal changes in choroidal thickness and choroidal vascularity index in age-related macular degeneration.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1