[1]刘子扬,夏松,杨景元,等.息肉状脉络膜血管病变抗血管内皮生长因子（VEGF）治疗后1年的视力预后与基线特征的相关性分析[J].眼科新进展,2018,38(5):440-443.[doi:10.13389/j.cnki.rao.2018.0102]
　LIU Zi-Yang,XIA Song,YANG Jing-Yuan,et al.Correlation of 1-year vision outcomes with baseline factors in polypoidal choroidal vasculopathy patients after anti-VEGF treatment[J].Recent Advances in Ophthalmology,2018,38(5):440-443.[doi:10.13389/j.cnki.rao.2018.0102]
点击复制

息肉状脉络膜血管病变抗血管内皮生长因子（VEGF）治疗后1年的视力预后与基线特征的相关性分析/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年5期
页码:
440-443
栏目:
应用研究
出版日期:
2018-05-05

文章信息/Info

Title:
Correlation of 1-year vision outcomes with baseline factors in polypoidal choroidal vasculopathy patients after anti-VEGF treatment
作者:
刘子扬; 夏松; 杨景元; 陈有信
100730　北京市，中国医学科学院，北京协和医学院，北京协和医院眼科
Author(s):
LIU Zi-Yang; XIA Song; YANG Jing-Yuan; CHEN You-Xin
Department of Ophthalmology，Peking Union Medical College Hospital，Peking Union Medical College，Chinese Academy of Medical Sciences，Beijing 100730，China
关键词:
息肉状脉络膜血管病变; 血管内皮生长因子; 最佳矫正视力; 脉络膜血管高渗透性
Keywords:
polypoidal choroidal vasculopathy; vascular endothelial growth factor; best corrected visual acuity; choroidal vascular hyperpermeability
分类号:
R773.4
DOI:
10.13389/j.cnki.rao.2018.0102
文献标志码:
A
摘要:
目的　分析息肉状脉络膜血管病变（polypoidal choroidal vasculopathy，PCV）经过连续3个月的每月抗血管内皮生长因子（vescular endothelial growth factor，VEGF）治疗后 1 a 的视力预后与基线特征的相关性。方法　回顾性队列研究。收集2015年7月至2016年12月于我院就诊的PCV患者44例（44眼），所有患者在基线时均行最佳矫正视力（best corrected visual acuity，BCVA）、眼压、眼底检查以及光学相干断层扫描、眼底荧光素血管造影和吲哚青绿血管造影检查。所有患者在确诊后均行连续3个月的每月1次抗VEGF（包括雷珠单抗和康柏西普）注射，随后按需治疗，记录第1次抗VEGF治疗后随访1 a的BCVA并与基线BCVA比较，依据BCVA变化分为BCVA提高组和未提高组，单因素和Logistic回归分析BCVA预后与基线特征的相关性。结果　单因素分析结果显示，BCVA提高组比BCVA未提高组具有较短的发病时间、较小的病灶最大线性尺寸（P=0.045、0.037）。Logistic回归结果显示，脉络膜高渗透性和病灶最大线性尺寸是视力预后的独立相关因素（回归系数为0.963和0.001；P=0.010、0.012；比值比为0.083和1.002；95%的可信区间为0.013~0.549和1.001~1.004 μm）。结论　合并脉络膜血管高渗透性可能是经抗VEGF治疗的PCV患眼视力预后不佳的预测指标，同时病灶的最大线性尺寸和发病时间也与PCV经抗VEGF治疗后的BCVA预后相关。
Abstract:
Objective　To analyze the correlation between baseline factors and the best corrected visual acuity （BCVA） after 3 monthly anti-vescular endothelial growth factor （VEGF） therapy in naive polypoidal choroidal vasculopathy （PCV）.Methods　This was a retrospective cohort study in 44 naive PCV patients （44 eyes） treated in our hospital between July 2015 and December 2016，and BCVA，optical coherence tomography （OCT） and fundus fluorescein angiography （FFA）+indocyanine green angiography （ICGA） examinations were performed at first.All patients were treated with monthly anti-VEGF （including ranibizumab and conbercept） injections for 3 consecutive months，followed by the needed retreatment，and BCVA at the 12th month during follow-up after the first anti-VEGF treatment was recorded，following the comparison with baseline BCVA，and then the patients were divided into improved and unimproved groups according to BCVA changes.Finally，univariate and logistic regression analysis were used to analyze the correlation between the baseline factors and BCVA.Results　The univariate analysis showed that the improved group had shorter onset time，smaller greatest linear dimension （P=0.045 and 0.037，respectively）.Logistic regression showed the difference in choroidal vascular hyperpermeability and greatest linear dimension was statistically significant，suggesting that they were the independent predictors of visual outcome （regression coefficient=0.963 and 0.001，P=0.010 and 0.012，odds ratios=0.083 and 1.002，95% confidence interval=0.013-0.549 and 1.001-1.004，respectively）.Conclusion　Choroidal vascular hyperpermeability may be a predictor for poor visual acuity prognosis in PCV patients after anti-VEGF，and greatest linear dimension and the time of onset are also related to postoperative visual acuity in PCV patients after anti-VEGF.

参考文献/References:

［1］　YANNUZZI LA，SORENSON J，SPAIDE RF，LIPSON B.Idiopathic polypoidal choroidal vasculopathy （IPCV）［J］.Retina，1990，10（1）：1-8.
［2］　CIARDELLA AP，DONSOFF IM，HUANG SJ，COSTA DL，YANNUZZI LA.Polypoidal choroidal vasculopathy［J］.Surv Ophthalmol，2004，49（1）：25-37.
［3］　GOMI F，TANO Y.Polypoidal choroidal vasculopathy and treatments［J］.Curr Opin Ophthalmol，2008，19（3）：208-212.
［4］　CACKETT P，HTOON H，WONG D，YEO I.Haemorrhagic pigment epithelial detachment as a predictive feature of polypoidal choroidal vasculopathy in a Chinese population［J］.Eye （Lond），2010，24（5）：789-792.
［5］　CHEUNG CM，LI X，MATHUR R，LEE SY，CHAN CM，YEO I，et al.A prospective study of treatment patterns and 1-year outcome of Asian age-related macular degeneration and polypoidal choroidal vasculopathy［J］.PLoS One，2014，9（6）：e101057.
［6］　CHO HJ，KIM JW，LEE DW.Intravitreal bevacizumab and ranibizumab injections for patients with polypoidal choroidal vasculopathy［J］.Eye （Lond），2012，26（3）：426-433.
［7］　HARA C，SAWA M，SAYANAGI K，NISHIDA K.One-year results of intravitreal aflibercept for polypoidal choroidal vasculopathy［J］.Retina，2016，36（1）：37-45.
［8］　INOUE M，ARAKAWA A，YAMANE S，KADONOSONO K.Long-term outcome of intravitreal ranibizumab treatment，compared with photodynamic therapy，in patients with polypoidal choroidal vasculopathy［J］.Eye （Lond），2013，27（9）：1013-1020.
［9］　KIKUSHIMA W，SAKURADA Y，SUGIYAMA A，TANABE N，KUME A，IIJIMA H.Comparison of initial treatment between 3-monthly intravitreal aflibercept monotherapy and combined photodynamic therapy with single intravitreal aflibercept for polypoidal choroidal vasculopathy［J］.Graefes Arch Clin Exp Ophthalmol，2017，255（2）：311-316.
［10］　KOH AH，EXPERT PCV PANEL，CHEN LJ，CHEN SJ，CHEN Y，GIRIDHAR A，et al.Polypoidal choroidal vasculopathy：evidence-based guidelines for clinical diagnosis and treatment［J］.Retina，2013，33（4）：686-716.
［11］　KOKAME GT，YEUNG L，LAI JC.Continuousanti-VEGF treatment with ranibizumab for polypoidal choroidal vasculopathy：an interim 6-month report［J］.Br J Ophthalmol，2010，94（3）：297-301.
［12］　KOH E，LEE WK，CHEN LJ，CHEN SJ，HASHAD Y，KIM H，et al.EVEREST study：efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy［J］.Retina，2012，32（8）：1453-1464.
［13］　HIKICHI T，HIGUCHI M，MATSUSHITA T，KOSAKA S，MATSUSHITA R，TAKAMI K，et al.Factors predictive of outcomes 1 year after 3 monthly ranibizumab injections and as-needed reinjections for polypoidal choroidal vasculopathy in Japanese patients［J］.Retina，2013，33（9）：1949-1958.
［14］　SAKURADA Y，SUGIYAMA A，TANABE N，KIKUSHIMA W，KUME A，IIJIMA H.Choroidal thickness as a prognostic factor of photodynamic therapy with aflibercept or ranibizumab for polypoidal choroidal vasculopathy［J］.Retina，2017，37（10）：1866-1872.
［15］　JAPANESE STUDY GROUP OF POLYPOIDAL CHOROIDAL VASCULOPATHY．Criteria for diagnosis of polypoidal choroidal vasculopathy［J］．Nippon Gakkai Zasshi，2005，109（7）：417-427．
［16］　SONODA S，SAKAMOTO T，OTSUKA H，YOSHINAGA N，YAMASHITA T，KII Y，et al.Responsiveness of eyes with polypoidal choroidal vasculopathy with choroidal hyperpermeability to intravitreal ranibizumab［J］.BMC Ophthalmol，2013，13：43.
［17］　KANG HM，KWON HJ，YI JH，LEE CS，LEE SC.Subfoveal choroidal thickness as a potential predictor of visual outcome and treatment response after intravitreal ranibizumab injections for typical exudative age-related macular degeneration［J］.Am J Ophthalmol，2014，157（5）：1013-1021.
［18］　KIM H，LEE SC，KWON KY，LEE JH，KOH HJ，BYEON SH，et al.Subfoveal choroidal thickness as a predictor of treatment response to anti-vascular endothelial growth factor therapy for polypoidal choroidal vasculopathy［J］.Graefes Arch Clin Exp Ophthalmol，2016，254（8）：1497-1503.
［19］　CHUNG SE，KANG SW，LEE JH，KIM YT.Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration［J］.Ophthalmology，2011，118（5）：840-845.
［20］　KOIZUMI H，YAMAGISHI T，YAMAZAKI T，KAWASAKI R，KINOSHITA S.Subfoveal choroidal thickness in typical age-related macular degeneration and polypoidal choroidal vasculopathy［J］.Graefes Arch Clin Exp Ophthalmol，2011，249（8）：1123-1128.
［21］　CHO HJ，KIM HS，JANG YS，HAN JI，LEW YJ，LEE TG，et al.Effects of choroidal vascular hyperpermeability on anti-vascular endothelial growth factor treatment for polypoidal choroidal vasculopathy［J］.Am J Ophthalmol， 2013，156（6）：1192-1200.
［22］　OKUBO A，SAMESHIMA M，UEMURA A，KANDA S，OHBA N.Clinicopathological correlation of polypoidal choroidal vasculopathy revealed by ultrastructural study［J］.Br J Ophthalmol，2002，86（10）：1093-1098.
［23］　LAFAUT BA，AISENBREY S，VAN DEN BROECKE C，BARTZ-SCHMIDT KU，HEIMANN K.Polypoidal choroidal vasculopathy pattern in age-related macular degeneration：a clinicopathologic correlation［J］.Retina，2000，20（6）：650-654.
［24］　KOIZUMI H，YAMAGISHI T，YAMAZAKI T，KINOSHITA S.Relationship between clinical characteristics of polypoidal choroidal vasculopathy and choroidal vascular hyperpermeability［J］.Am J Ophthalmol，2013，155（2）：305-313.
［25］　CHUNG SE，KANG SW，KIM JH，KIM YT，PARK DY.Engorgement of vortex vein and polypoidal choroidal vasculopathy［J］.Retina，2013，33（4）：834-840.
［26］　YANAGI Y，TING DSW，NG WY，LEE SY，MATHUR R，CHAN CM，et al.Choroidal vascular hyperpermeability as a predictor of treatment response for polypoidal choroidal vasculopathy［J］.Retina，2017，［Epub ahead of print］.
［27］　SCHMIDT-ERFURTH UM，MICHELS S，KUSSEROW C，JURKLIES B，AUGUSTIN AJ.Photodynamic therapy for symptomatic choroidal hemangioma：visual and anatomic results［J］.Ophthalmology，2002，109（12）：2284-2294.
［28］　LEE WK，LEE PY，LEE SK.Photodynamic therapy for polypoidal choroidal vasculopathy：vaso-occlusive effect on the branching vascular network and origin of recurrence［J］.Jpn J Ophthalmol，2008，52（2）：108-115.

相似文献/References:

[1]程文武 江萍 席祖莲 张汉武 訾世莉 聂军 董彩虹.蛹虫草提取物抑制大鼠角膜新生血管的实验研究[J].眼科新进展,2012,32(5):000.
[2]于静 张明昌.苦参碱对大鼠角膜新生血管的抑制作用[J].眼科新进展,2012,32(6):000.
[3]吴正正 严京 接传红 高健生 陈皆春 宋剑涛.密蒙花方对缺氧状态下脐静脉血管内皮细胞 VEGF-VEGFR 信号转导通路的影响[J].眼科新进展,2012,32(7):000.
[4]庞霞 曲蕴慧 马跃伟 张效房 董敬民 高冬玲.去整合素金属蛋白酶9和血管内皮生长因子蛋白在眼部恶性黑色素瘤中的表达[J].眼科新进展,2012,32(7):000.
[5]刘延东.息肉状脉络膜血管病变眼底影像检查特征[J].眼科新进展,2012,32(12):000.
[6]李艳 李筱荣 袁佳琴 潘斌.糖尿病大鼠视网膜中VEGF、PEDF的表达与血-视网膜屏障损伤[J].眼科新进展,2013,33(1):000.
[7]许琴 黄亮 林素香 郑水华 肖煜晨 王雅丽.激光诱导小鼠脉络膜新生血管中膜攻击物与血管生长因子的表达[J].眼科新进展,2013,33(8):000.
[8]李小璐 马雅玲.糖尿病视网膜病变大鼠视网膜VEGF和PEDF的动态表达[J].眼科新进展,2013,33(9):000.
[9]曾莉 常以力 邵毅.血管内皮生长因子反义寡脱氧核苷酸联合血管生成素-1对糖尿病视网膜病变大鼠视网膜血管渗漏及新生血管生成的影响[J].眼科新进展,2012,32(10):000.
[10]兰兰 惠延年 曾光伟.血管生成素-1对糖尿病大鼠视网膜微血管病变、基质金属蛋白酶和血管内皮生长因子的抑制作用[J].眼科新进展,2012,32(10):000.
[11]刘华,许多,陈艳丽,等.康柏西普治疗息肉状脉络膜血管病变的临床疗效[J].眼科新进展,2018,38(12):1144.[doi:10.13389/j.cnki.rao.2018.0270]
　LIU Hua,XU Duo,CHEN Yan-Li,et al.Clinical efficacy of conbercept in the treatment of polypoidal choroidal vasculopathy[J].Recent Advances in Ophthalmology,2018,38(5):1144.[doi:10.13389/j.cnki.rao.2018.0270]
[12]李凤媚,宋艳萍.康柏西普玻璃体内重复注射治疗息肉状脉络膜血管病变疗效及相关因素分析[J].眼科新进展,2019,39(10):969.[doi:10.13389/j.cnki.rao.2019.0221]
　LI Feng-Mei,SONG Yan-Ping.Efficacy of intravitreal injection of conbercept in polypoidal choroidal vasculopathy and its related factors[J].Recent Advances in Ophthalmology,2019,39(5):969.[doi:10.13389/j.cnki.rao.2019.0221]

备注/Memo

备注/Memo:
国家自然科学基金资助（编号：81670879）
更新日期/Last Update: 2018-05-09