Early Fluctuations of Exudative Lesions as Predictors of Two-Year Clinical Outcomes in Neovascular Age-Related Macular Degeneration.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Translational Vision Science & Technology Pub Date : 2025-10-01 DOI:10.1167/tvst.14.10.1

Jiaxin Pu, Xuenan Zhuang, Miaoling Li, Xinlei Hao, Guiqin He, Yongyue Su, Linling Xia, Feng Wen

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引用次数: 0

Abstract

Purpose: To investigate how early fluctuations of exudative lesions correlate with 2-year outcomes in neovascular age-related macular degeneration (nAMD).

Methods: This prospective study included 92 treatment-naïve nAMD eyes treated with anti-vascular endothelial growth factor (anti-VEGF) therapy using a 3+PRN regimen over 2 years. Volumes of seven exudative lesion types were measured: subretinal fluid (SRF); intraretinal fluid (IRF); vascular and avascular subretinal hyperreflective material (vSHRM and avSHRM, respectively); and serous, fibrovascular, and hemorrhagic pigment epithelial detachment (sPED, fvPED, and hPED, respectively). Four fluctuation parameters were calculated during the 3-month loading phase. Relationships between these early fluctuations and clinical outcomes, including best-corrected visual acuity (BCVA) and injection frequency, were analyzed.

Results: A total of 92 eyes (92 patients) were included, with a mean age of 65.65 ± 7.20 years. After adjusting for baseline characteristics, fluctuations in both vSHRM and avSHRM were identified as independent predictors of 2-year BCVA prognosis, with greater fluctuations associated with poorer visual outcomes (vSHRM Stdβ range, 0.671-0.797; avSHRM Stdβ range, 0.722-0.856; all P ≤ 0.001). However, only IRF fluctuation metrics were found to be independently associated with injection frequency over 2 years (Stdβ range, 0.327-0.532; all P < 0.05), with greater fluctuations correlating with more frequent injections.

Conclusions: SHRM fluctuations during the loading phase predict 2-year visual outcomes, and IRF variations correlate with injection frequency in nAMD.

Translational relevance: Early fluctuation patterns of exudative lesions can serve as predictive biomarkers to guide personalized anti-VEGF treatment strategies and optimize long-term visual outcomes in nAMD patients.

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渗出性病变的早期波动作为新血管性年龄相关性黄斑变性两年临床结果的预测因子。

目的：探讨渗出性病变的早期波动与新生血管性年龄相关性黄斑变性（nAMD） 2年预后的关系。方法：这项前瞻性研究包括92只treatment-naïve nAMD眼睛，采用抗血管内皮生长因子（anti-VEGF）治疗，采用3+PRN方案，为期2年。测量了7种渗出性病变类型的体积：视网膜下液（SRF）；视网膜内液；血管和无血管视网膜下高反射材料（分别为vSHRM和avSHRM）；浆液性、纤维血管性和出血性色素上皮脱离（分别为sPED、fvPED和hPED）。在3个月的加载阶段计算了4个波动参数。分析了这些早期波动与临床结果（包括最佳矫正视力（BCVA）和注射频率）之间的关系。结果：共纳入92只眼92例，平均年龄65.65±7.20岁。在调整基线特征后，vSHRM和avSHRM的波动均被确定为2年BCVA预后的独立预测因子，波动越大与视力结果越差相关（vSHRM Stdβ范围0.671-0.797；avSHRM Stdβ范围0.722-0.856；所有P≤0.001）。然而，2年内只有IRF波动指标与注射频率独立相关（Stdβ范围0.327-0.532，均P < 0.05），波动越大与注射频率越高相关。结论：加载阶段的SHRM波动预测了2年的视觉结果，而IRF变化与nAMD的注射频率相关。翻译相关性：渗出性病变的早期波动模式可以作为预测性生物标志物，指导个性化的抗vegf治疗策略，优化nAMD患者的长期视力结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational Vision Science & Technology Engineering-Biomedical Engineering

CiteScore

5.70

自引率

3.30%

发文量

346

审稿时长

25 weeks

期刊介绍： Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.