《新生血管性年龄相关性黄斑变性的最佳治疗—延长方案(2022中国台湾)共识》解读  

Interpretation of Consensus on the Optimal Treat-and-Extend Regimen of Neovascular Age-Related Macular Degeneration (2022 Taiwan, China)

作　　者：王滨 马华锋[1,2] 李会[1,2] Bin Wang;Hua-Feng Ma;Hui Li(Chongqing Medical University,Chongqing 400016,China;Department of Ophthalmology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学,重庆市400016 [2]重庆医科大学附属第二医院眼科,重庆市400010

出　　处：《国际眼科杂志》2022年第9期1478-1484,共7页International Eye Science

摘　　要：中国台湾眼底病专家组在2022年发布了《新生血管性年龄相关性黄斑变性的最佳治疗—延长方案共识》,为了帮助我国眼科医生更好地参考和使用该共识,以下进行解释说明,主要内容如下:新生血管性年龄相关性黄斑变性(nARMD)患者抗血管内皮生长因子(VEGF)治疗的治疗-延长(T&E)方案应以维持长期视力和减少注射次数为目标,可采用连续3mo每月注射1次的启动治疗,病情稳定者逐步(每次2或4wk)延长治疗间隔,最长至16wk,以最长间隔连续注射2或3次后病情仍稳定者可暂停治疗,之后每3~4wk复查1次;疾病活动则逐步缩短治疗间隔,稳定后可再次延长。对于存在明显负性愈后因素的患者,可采取相对保守的疗法。治疗期间需关注结膜下出血、黄斑纤维化、黄斑萎缩等并发症。未来需探索不同亚型及基线病情nARMD患者的最佳注射方案,以实现最佳个性化治疗。·In 2022,the Taiwan,China fundus disease expert group issued the Consensus on the Optimal Treat-and-Extend Regimens for Neovascular Age-Related Macular Degeneration.The following explanations are given to help Chinese ophthalmologists better to refer to and use the Consensus.The main contents are as follows:The treat-and-extend(T&E)regimen of anti-vascular endothelial growth factor(VEGF)treatment in patients with neovascular age-related macular degeneration(nARMD)should aim at maintaining long-term vision and reducing the number of injections.We can start the treatment by injecting once a month for consecutive 3mo.After the initial treatment,the treatment interval of patients with stable conditions can be gradually extended(2 or 4wk each time)until 16wk.If the disease is still steady after injecting 2 or 3 times at the most prolonged interval,we can suspend the treatment,and then the patient needs to be rechecked every 3-4mo;If the disease is active again,the treatment interval needs to be shortened and can be extended again after controlling the disease.We can adopt a relatively conservative approach for patients with apparent negative recovery factors.Complications such as subconjunctival hemorrhage,macular fibrosis and macular atrophy deserve our attention during treatment.In the future,we can explore the best injection scheme for nARMD patients with different subtypes and baseline conditions to realize personalized therapy.

关 键 词：血管内皮生长因子 年龄相关性黄斑变性 治疗—延长 共识 

分 类 号：R774.5[医药卫生—眼科]