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IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology Pub Date : 2025-03-01 DOI:10.1016/j.apjo.2025.100176

Voraporn Chaikitmongkol , Wantip Tadadoltip , Direk Patikulsila , Titipol Srisomboon , Chanusnun Narongchai , Janejit Choovuthayakorn , Nawat Watanachai , Paradee Kunavisarut , Apisara Sangkaew , Phit Upaphong , Neil M. Bressler

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引用次数: 0

摘要

目的：多形性脉络膜血管病（PCV）在积液消退后可能会频繁复发，但复发时间尚不清楚。本研究探讨了固定剂量的阿弗利百普治疗 1 年后首次息肉样复发的时间：回顾性队列研究方法：确定并纳入 2015 年 4 月至 2019 年 5 月间接受治疗的 PCV 患者，纳入标准包括：（1）第一年接受固定剂量 2mg aflibercept；（2）治疗后第 1 年（PTY1）"无活动"（OCT 上视网膜内和视网膜下均无积液），此后按需管理（PRN）；（3）PTY1 后 FU ≥12 个月。对眼底摄影、吲哚菁绿血管造影（ICGA）和 OCT 进行分级，以确定复发的时间和风险因素（定义为 OCT 上的积液）：在 37 位研究对象（37 位患者；中位年龄为 64 岁（IQR 59-69）；中位阿弗利百普注射次数为 8 次（IQR 8-8）；中位治疗时间为 38 个月（IQR 30 至 50 个月））中，有 18 只眼睛（49%）在治疗期间复发。18只眼睛中有14只（78%）在PTY1就诊后12个月内复发。复发的风险因素包括：治疗后 ICGA 显示息肉不完全消退[P =.004，危险比 (HR) = 4.4，95% 置信区间 (CI) 1.6 至 11.9]，以及治疗后 OCT 显示内部异质反射的 PED（P =.04，HR = 2.7，95% CI 1.1 至 6.9）：近一半的非活动性PCV眼在接受为期1年的固定剂量aflibercept治疗后会复发息肉样病变。具有复发高风险特征的眼睛可能需要密切监测，其中一些特征可通过 OCT 检测到，而无需 ICGA。

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Recurrent polypoidal lesions after achieving inactive polypoidal choroidal vasculopathy following 1-year fixed-dosing aflibercept treatments

Purpose

Polypoidal choroidal vasculopathy (PCV) may have frequent recurrences after fluid resolution, but time to recurrence is unclear. This study explored time to first polypoidal recurrence after 1-year fixed-dosing aflibercept treatments.

Design

Retrospective cohort study.

Methods

Treatment-naïve PCV eyes treated between April 2015 to May 2019 were identified and included with criteria including: (1) received fixed-dosing 2 mg aflibercept in the first year, (2) became “inactive” (absence of both intraretinal and subretinal fluid on OCT) at post-treatment year-1 (PTY1) and managed as needed (PRN) thereafter, (3) FU ≥ 12 months after PTY1. Fundus photography, indocyanine green angiography (ICGA), and OCT graded to identify timing and risk factors for recurrence (defined as fluid on OCT).

Results

Of 37 study eyes [37 patients; median age was 64 years (IQR 59–69); median aflibercept injection number was 8 (IQR 8–8); median FU 38 months (IQR, 30–50 months)]; 18 eyes (49 %) had recurrence during FU. Fourteen (78 %) of 18 had recurrence within 12 months after PTY1 visit. Risk factors for recurrence included: incomplete polypoidal regression on post-treatment ICGA [P = .004, Hazard ratio (HR) = 4.4, 95 % confidence interval (CI) 1.6–11.9] and PED with internal heterogeneous reflectivity on post-treatment OCT (P = .04, HR = 2.7, 95 % CI 1.1–6.9).

Conclusions

Nearly half of inactive PCV eyes following 1-year fixed-dosing aflibercept treatments had recurrent polypoidal lesions. Eyes with high-risk features for recurrence, some of which can be detected with OCT without the need for ICGA, may warrant close monitoring.

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来源期刊

Asia-Pacific Journal of Ophthalmology OPHTHALMOLOGY-

CiteScore

8.10

自引率

18.20%

发文量

197

审稿时长

6 weeks

期刊介绍： The Asia-Pacific Journal of Ophthalmology, a bimonthly, peer-reviewed online scientific publication, is an official publication of the Asia-Pacific Academy of Ophthalmology (APAO), a supranational organization which is committed to research, training, learning, publication and knowledge and skill transfers in ophthalmology and visual sciences. The Asia-Pacific Journal of Ophthalmology welcomes review articles on currently hot topics, original, previously unpublished manuscripts describing clinical investigations, clinical observations and clinically relevant laboratory investigations, as well as .perspectives containing personal viewpoints on topics with broad interests. Editorials are published by invitation only. Case reports are generally not considered. The Asia-Pacific Journal of Ophthalmology covers 16 subspecialties and is freely circulated among individual members of the APAO’s member societies, which amounts to a potential readership of over 50,000.