Factors predictive of treatment outcomes in submacular hemorrhage secondary to age-related macular degeneration.

IF 2.1 3区 医学 Q2 OPHTHALMOLOGY
Yuto Watanabe, Takashi Koto, Aya Takahashi, Masaharu Mizuno, Tomoka Ishida, Kosuke Nakajima, Jun Takeuchi, Tadashi Yokoi, Makiko Nakayama, Annabelle A Okada, Makoto Inoue, Keiko Kataoka
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Abstract

Purpose: To identify predictors for visual outcomes of eyes with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD).

Study design: Retrospective observational study.

Methods: Clinical data from patients diagnosed with SMH secondary to nAMD and treated with pneumatic displacement were collected. SMH thickness was measured by optical coherence tomography (OCT) at baseline and 1 week. Possible factors associated with best-corrected visual acuity (BCVA) gain at 3 months were analyzed.

Results: Fifty-six eyes of 56 patients (18 female/38 male; mean age, 77.8 ± 10.1 years) were analyzed; 34 were treatment-naïve and 22 were previously treated with anti-vascular endothelial growth factor agents. Multivariable analysis showed that greater BCVA gain more than 0.3 logMAR at 3 months post-treatment was associated with being treatment-naïve (odds ratio [OR], 34.30; 95% confidence interval [CI], 1.38-851.91; P = 0.031), thinner SMH thickness at 1 week after pneumatic displacement (OR, 0.38 per 50-unit increase; CI, 0.18-0.80; P = 0.011), and worse baseline BCVA (OR, 2.58 per 0.1-unit increase; CI, 1.31-5.07; P = 0.006), but not associated with age (OR, 0.50; 95% CI, 0.24-1.06), the time from onset to pneumatic displacement (OR, 1.04; 95%CI, 0.87-1.23), SMH thickness at baseline (OR, 0.92; 95%CI, 0.63-1.36), and the presence of subfoveal hemorrhagic PED (OR, 0.72; 95%CI, 0.08-6.84).

Conclusion: This study identifies novel factors predictive of visual outcomes for pneumatic displacement for SMH due to nAMD. The presence of residual SMH at 1 week following unsuccessful pneumatic displacement may warrant further intervention.

年龄相关性黄斑变性继发黄斑下出血治疗结果的预测因素。
目的:确定黄斑下出血(SMH)继发于新生血管性年龄相关性黄斑变性(nAMD)的视力预后的预测因素。研究设计:回顾性观察性研究。方法:收集诊断为nAMD继发SMH并采用气动置换治疗的患者的临床资料。在基线和1周时通过光学相干断层扫描(OCT)测量SMH厚度。分析3个月最佳矫正视力(BCVA)增加的可能因素。结果:56例患者56只眼,其中女性18只/男性38只;平均年龄(77.8±10.1岁);34名患者treatment-naïve, 22名患者先前接受过抗血管内皮生长因子治疗。多变量分析显示,治疗后3个月BCVA增益大于0.3 logMAR与treatment-naïve相关(比值比[OR], 34.30;95%置信区间[CI], 1.38-851.91;P = 0.031),气动位移后1周SMH厚度变薄(OR,每增加50个单位0.38;CI, 0.18 - -0.80;P = 0.011),基线BCVA更差(OR为每增加0.1个单位2.58;CI, 1.31 - -5.07;P = 0.006),但与年龄无关(OR, 0.50;95% CI, 0.24-1.06),从发病到气动位移的时间(OR, 1.04;95%CI, 0.87-1.23),基线SMH厚度(OR, 0.92;95%CI, 0.63-1.36),以及存在中央凹下出血性PED (OR, 0.72;95%可信区间,0.08 - -6.84)。结论:本研究确定了预测因nAMD导致的SMH气动置换的视觉结果的新因素。在不成功的气动置换后1周,残余SMH的存在可能需要进一步的干预。
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来源期刊
CiteScore
4.80
自引率
8.30%
发文量
65
审稿时长
6-12 weeks
期刊介绍: The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.
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