真实世界中玻璃体腔注射抗血管内皮生长因子药物在新生血管性眼病中的应用疗效  

Real-world Outcomes in Patients with Neovascular Ocular Disease Treated with Anti-Vascular Endothelial Growth Factor Therapy

作　　者：曾婧[1] 刘笑 刘志平[1] 沙翔垠[1] ZENG Jing;LIU Xiao;LIU Zhiping;SHA Xiangyin(Department of Ophthalmology the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院眼科

出　　处：《实用医学杂志》2020年第3期369-374,共6页The Journal of Practical Medicine

基　　金：广东省自然科学基金面上项目(编号：2015A03031347);广州市科技计划一般项目(编号：201804010038);广州市属高校羊城学者青年科研骨干培养项目(编号：1201581612)

摘　　要：目的研究分析真实世界中玻璃体腔注射抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物在新生血管性眼病中的应用疗效。方法回顾性分析2016年10月至2018年6月在我科接受抗VEGF治疗的新生血管性眼病病例。所有病例均详细记录治疗前和治疗后1 d、治疗后1周的最佳矫正视力(LogMAR)、眼压、眼底情况。并对纳入病例的资料特征、所用药物、治疗方案、注药次数、疗效等指标进行分析比较。结果纳入符合条件的临床病例227例313眼,其中93例163眼为糖尿病视网膜病变(diabetic retinopathy,DR),45例58眼为湿性年龄相关性黄斑变性(wet age⁃related macular degenera⁃tion,wAMD),26例29眼为息肉样脉络膜血管病变(polyloidal choroidal vasculopathy,PCV),39例39眼为视网膜静脉阻塞(retinal vein occlusion,RVO),13例13眼为病理性近视伴发脉络膜新生血管(myopic choroi⁃dal neovascularization,PM⁃CNV),4例4眼为特发性脉络膜新生血管(idiopathic choroidal neovascularization,ICNV),4例4眼为新生血管性青光眼(neovascular glaucoma,NVG),余3例3眼为其他眼病。单眼注药141例,双眼注药86例。22.0%的患眼实施了3+PRN方案,78.0%的患眼实施了1+PRN方案。雷珠单抗治疗的有152眼,康柏西普治疗的有140眼,有21眼在治疗过程中更换了药物。所有患者共计接受抗VEGF治疗544次,平均(1.8±1.0)次/眼。总体治疗后平均LogMAR视力(0.92±0.76)与基线(1.12±0.84)差异有统计学意义(P<0.001)。结论抗VEGF治疗确可有效促进患者视功能的恢复、减少视力损害,是临床上治疗新生血管性眼病的一线治疗用药。但在真实世界中,抗VEGF药物的应用仍然受多方面因素影响。Objective To explore the treatment efficacy of anti⁃vascular endothelial growth factor(anti⁃VEGF)therapy in neovascular ocular diseases in the real world.Methods This was a retrospective study.Patients with neovascular ocular disease who had received anti⁃VEGF therapy were included from October 2016 to June 2018.Best corrected visual acuity(BCVA,LogMAR),intraocular pressure,and fundus examinations were performed at baseline,post⁃operative day 1,and post⁃operative week 1.The demographic characteristics,treat⁃ment strategies,frequency of injections,treatment efficacy were evaluated in the present study.Results Three hundred thirteen eyes of 227 patients were included in this study.One hundred sixty⁃three eyes of 93 patients were diagnosed as diabetic retinopathy(DR).Fifty⁃eight eyes of 45 patients were wet age⁃related macular degeneration(wAMD).Twenty⁃nine eyes of 26 patients were polypoidal choroidal vasculopathy(PCV).Thirty⁃nine eyes of 39 patients were retinal vein occlusion(RVO).Thirteen eyes of 13 patients were myopic choroidal neovascularization(PM⁃CNV).Four eyes of 4 patients were idiopathic choroidal neovascularization(ICNV).Four eyes of 4 patients were neovascular glaucoma(NVG).Three eyes of 3 patients were diagnosed as other diseases.One hundred forty⁃one patients had received unilateral intravitreal injections,while 86 patients had received bilateral intravitreal injec⁃tions.Sixty⁃nine eyes(22.0%)were treated with 3+PRN program while 244 eyes(78.0%)were treated with 1+PRN program.One hundred fifty⁃two eyes were only injected Ranibizumab.One hundred forty eyes were only inject⁃ed Conbercept. Twenty⁃one eyes had switched the medicine during treatment. Totally,there were 577 anti⁃VEGF injections in 227 patients. BCVA at final visit(0.92 ± 0.76)was improved significantly than at baseline[(1.12 ± 0.84),P < 0.001]in the whole population. Conclusion Anti⁃VEGF therapy is the first⁃line treatment for neovascular ocular diseases. It can promote the rehabilitation of the

关 键 词：血管内皮生长因子 抗血管内皮生长因子药物 新生血管 玻璃体腔注射 真实世界 

分 类 号：R77[医药卫生—眼科]