因视网膜分支静脉闭塞导致黄斑水肿而放弃抗血管内皮生长因子疗法的患者特征。

IF 1.8 4区 医学 Q3 OPHTHALMOLOGY
Journal of Ophthalmology Pub Date : 2024-07-05 eCollection Date: 2024-01-01 DOI:10.1155/2024/8336516
Setsuko Kawakami, Yoshihiro Wakabayashi, Yoko Watanabe, Kazuhiko Umazume, Kaori Yamamoto, Hiroshi Goto
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引用次数: 0

摘要

目的:研究视网膜分支静脉闭塞(BRVO)继发性黄斑水肿(ME)抗血管内皮生长因子(VEGF)治疗的退出率,并确定退出病例的特征:我们研究了235名接受雷尼珠单抗玻璃体内注射治疗的BRVO-ME患者的235只眼睛。当ME复发或持续存在时,给予额外的玻璃体内抗VEGF药物,并根据需要进行光凝。首次注射后 2 年内 ME 消失,且复发时间超过 6 个月,或 ME 仍有轻度复发,但视力在 6 个月内没有恶化,且未追加抗血管内皮生长因子药物,即为坚持治疗直至治疗结束。在 ME 复发的患者中,随访 2 年以上者视为坚持治疗,随访不足 2 年者视为放弃治疗。对两组患者的临床病程和背景进行了比较:结果:179 名患者(76.2%)坚持治疗,56 名患者(23.8%)退出治疗。坚持治疗组和退出治疗组的平均随访时间分别为 23.4 个月和 7.1 个月。两组患者在年龄、性别比例、从家到医院的距离、视力和眼窝厚度(FT)等人口统计学和基线因素方面无明显差异。在最后一次随访中,辍学组的视力明显差于坚持治疗组(0.23 对 0.11 logMAR,P=0.003),辍学组的眼窝厚度明显大于坚持治疗组(316 对 273 µm,P=0.002)。退出的原因包括:12.5%的患者拒绝进一步治疗,8.9%的患者痴呆症进展,64.3%的患者其他原因或原因不明:与坚持治疗的患者相比,放弃抗血管内皮生长因子治疗的BRVO-ME患者的临床疗效更差,而放弃治疗的原因也各不相同。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characteristics of Patients Who Drop Out of Anti-Vascular Endothelial Growth Factor Therapy for Macular Edema Associated with Branch Retinal Vein Occlusion.

Purpose: To investigate the dropout rate of anti-vascular endothelial growth factor (VEGF) treatment for macular edema (ME) secondary to branch retinal vein occlusion (BRVO) and identify the characteristics of dropout cases.

Methods: We studied 235 eyes of 235 treatment-naïve BRVO-ME patients receiving intravitreal injection of ranibizumab. Additional intravitreal anti-VEGF drug was given when ME relapsed or persisted, and photocoagulation was performed as needed. Adherence until treatment completion was defined as disappearance of ME within 2 years after the first injection without recurrence for more than 6 months or mild ME remaining but no visual deterioration for more than 6 months without additional anti-VEGF drug. In patients with ME recurrence, those who were followed for more than 2 years were considered adherence, and those followed for less than 2 years were considered dropout. The clinical course and background of the two groups were compared.

Results: 179 patients (76.2%) adhered to treatment and 56 patients (23.8%) dropped out. Mean follow-up periods in adherence and dropout groups were 23.4 and 7.1 months, respectively. There were no significant differences between the two groups in demographic and baseline factors of age, gender ratio, distance from home to hospital, visual acuity, and foveal thickness (FT). At the last follow-up, visual acuity was significantly poorer in the dropout group than in the adherence group (0.23 vs. 0.11 logMAR, p=0.003), and FT was significantly greater in the dropout group than in the adherence group (316 vs. 273 µm, p=0.002). Reasons for dropout included patient declining further treatment in 12.5%, progression of dementia in 8.9%, others, and unknown in 64.3%.

Conclusion: The clinical outcome of patients who dropped out of anti-VEGF therapy for BRVO-ME was worse compared to patients who adhered to therapy, and the reasons for discontinuation varied.

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来源期刊
Journal of Ophthalmology
Journal of Ophthalmology MEDICINE, RESEARCH & EXPERIMENTAL-OPHTHALMOLOGY
CiteScore
4.30
自引率
5.30%
发文量
194
审稿时长
6-12 weeks
期刊介绍: Journal of Ophthalmology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the anatomy, physiology and diseases of the eye. Submissions should focus on new diagnostic and surgical techniques, instrument and therapy updates, as well as clinical trials and research findings.
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