真实世界下眼内注射抗VEGF治疗眼底血管性疾病无应答的影响因素  

Factors influencing real-world non-response to intraocular injection of anti-vascular endothelial growth factor in the treatment of fundus vascular disease

作　　者：张晓光 于静 袁月 周润海 Zhang Xiaoguang;Yu Jing;Yuan Yue;Zhou Runhai(Department of Ophthalmology,General Hospital of Northern Command,Shenyang 110001,Liaoning Province,China)

机构地区：[1]中国人民解放军北部战区总医院眼科,中国辽宁省沈阳市110001

出　　处：《国际眼科杂志》2024年第11期1831-1835,共5页International Eye Science

摘　　要：目的:研究真实世界下玻璃体腔注射抗血管内皮生长因子(VEGF)治疗眼底血管性疾病无应答的影响因素。方法:回顾性分析。纳入2016-10/2022-10本院收治的眼底血管性疾病患者160例160眼,其中湿性年龄相关性黄斑变性(wARMD)64眼(40.0%),息肉状脉络膜血管(PCV)17眼(10.6%),糖尿病性黄斑水肿(DME)45眼(28.1%)、视网膜静脉阻塞继发黄斑水肿(RVO-ME)26眼(16.3%)、高度近视继发脉络膜新生血管(PM-CNV)8眼(5.0%)。所有患者均进行3+PRN抗VEGF治疗。根据患者第3次抗VEGF治疗后1 mo的应答情况分为应答有效组135眼(84.4%)和无应答组25眼(15.6%)。分析影响抗VEGF治疗眼底血管性疾病治疗的因素。结果:两组患者年龄、术前BCVA、视网膜内高反射点(HRD)、PCV、视网膜下强反射物质(SHRM)、PM-CNV比较均有差异(均P<0.05)。Logistics回归分析提示术前BCVA差,年龄大,视网膜内HRD、SHRM、PCV、PM-CNV是影响玻璃体腔注射抗VEGF治疗眼底血管性疾病无应答的因素。结论:抗VEGF治疗眼底血管性疾病无应答与年龄、基线视力、病理类型因素相关。需要对病例进行个体化分析,探索更适合的最佳个性化治疗方案。AIM:To investigate the factors influencing non-response to intravitreal injection of anti-vascular endothelial growth factor(VEGF)therapy in fundus vascular diseases in a real-world setting.METHODS:A retrospective analysis was conducted on 160 patients(160 eyes)with fundus vascular diseases,including 64 eyes(40.0%)of wet age-related macular degeneration(wARMD),17 eyes(10.6%)of polypoidal choroidal vasculopathy(PCV),45 eyes(28.1%)of diabetic macular edema(DME),26 eyes(16.3%)of retinal vein occlusion-macular edema(RVO-ME),and 8 eyes(5.0%)of choroidal neovascularization(PM-CNV).All patients received 3+PRN anti-VEGF therapy.Factors influencing anti-VEGF treatment on the fundus vascular diseases were analyzed.RESULTS:There were statistical significant difference in age,preoperative best corrected visual acuity(BCVA),hyper reflective dots(HRD),PCV,subretinal hyperreflective material(SHRM),and PM-CNV(all P<0.05).Logistics regression analysis noted that poor preoperative BCVA,age,intraretinal HRD,SHRM,PCV and PM-CNV were influencing factors of non-response to intravitreal injection of anti-VEGF in the treatment of fundus vascular diseases.CONCLUSION:Non-response to anti-VEGF therapy in patients with fundus vascular diseases is associated with various factors,including age,baseline visual acuity,and disease pathology.Individualized treatment strategies should be explored to optimize outcomes for non-responding patients.

关 键 词：抗血管内皮生长因子(VEGF)治疗 眼底血管性疾病 玻璃体腔内注射 真实世界 

分 类 号：R77[医药卫生—眼科]