[1]叶蓉,张秋阳,张荟颖,等.不同类型脉络膜新生血管患者对抗VEGF药物治疗应答的差异性[J].眼科新进展,2022,42(12):952-956.[doi:10.13389/j.cnki.rao.2022.0195]
　YE Rong,ZHANG Qiuyang,ZHANG Huiying,et al.Differences in responses to anti-vascular endothelial growth factor drugs of patients with different types of choroidal neovascularization[J].Recent Advances in Ophthalmology,2022,42(12):952-956.[doi:10.13389/j.cnki.rao.2022.0195]
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
42卷
期数:
2022年12期
页码:
952-956
栏目:
应用研究
出版日期:
2022-12-05

文章信息/Info

Title:
Differences in responses to anti-vascular endothelial growth factor drugs of patients with different types of choroidal neovascularization
作者:
叶蓉; 张秋阳; 张荟颖; 曹原; 蒋沁
210000　江苏省南京市，南京医科大学附属眼科医院
Author(s):
YE Rong; ZHANG Qiuyang; ZHANG Huiying; CAO Yuan; JIANG Qin
The Affiliated Eye Hospital of Nanjing Medical University,Nanjng 210000,Jiangsu Province,China
关键词:
病理性近视; 脉络膜新生血管; 视网膜色素上皮细胞; 抗血管内皮生长因子
Keywords:
pathological myopia;  choroidal neovascularization;  retinal pigment epithelium cells;  anti-vascular endothelial growth factor
分类号:
R773.4
DOI:
10.13389/j.cnki.rao.2022.0195
文献标志码:
A
摘要:
目的　探讨不同类型脉络膜新生血管(CNV)患者对抗血管内皮生长因子（VEGF）药物治疗应答的差异性。方法　本研究为回顾性研究。选取2016年10月至2021年9月在我院门诊确诊并接受康柏西普治疗的CNV患者50例68眼。依据CNV类型将患者分成3组，I型CNV组患者16例20眼，II型CNV组患者25例35眼，混合型CNV组患者9例13眼。采用德国海德堡公司共焦激光同步血管造影系统的增强扫描技术扫描获得患者黄斑中心凹脉络膜厚度(SFCT)，记录患者治疗前后相应时间点的最佳矫正视力(BCVA) (logMAR)，记录治疗后不同时间患者注药次数、需再治疗眼数和患者CNV复发率等。采用SPSS 23.0统计学软件对所得数据进行统计分析。结果　II型CNV组患者治疗后1周、1个月及2个月的BCVA较基线提高量高于I型CNV组和混合型CNV组，差异均有统计学意义(均为P<0.05)；混合型CNV组患者治疗后6个月、8个月及12个月BCVA较基线提高量低于I型CNV组和II型CNV组，差异均有统计学意义(均为P<0.05)。三组患者治疗后SFCT较基线均有所提高，差异均有统计学意义(均为P<0.05)。混合型CNV组患者治疗后8个月、12个月的SFCT较基线恢复厚度低于I型CNV组和II型CNV组，差异均有统计学意义(均为P<0.05)。随访0~24个月，三组患者总注药次数差异有统计学意义(P<0.05)，SNK-q检验结果显示:I型CNV组及II型CNV组患者注药次数少于混合型CNV组(均为P<0.05)。三组患者需再治疗眼率差异有统计学意义(P<0.05)；混合型CNV组患者需再治疗眼率高于I型CNV组及II型CNV组［需再治疗眼数率差95%CI分别为(0.051，0.133)和(0.041,0.142)］。三组患者注药后复发率差异无统计学意义(P>0.05)。结论　II型CNV在抗VEGF治疗早期应答更好，而II型CNV及I型CNV在治疗后期应答反应趋于相近；混合型CNV在治疗后期应答不良。
Abstract:
Objective　To investigate the different responses to anti-vascular endothelial growth factor (anti-VEGF) drugs of patients with various types of choroidal neovascularization (CNV). Methods　This study was a retrospective study. A total of 50 patients (68 eyes) who were diagnosed with CNV and treated with Conbercept in the Outpatient Department of our hospital from October 2016 to September 2021 were included. The patients were divided into 3 groups according to the type of CNV: 16 patients (20 eyes) in the type I CNV group, 25 patients (35 eyes) in the type II CNV group, and 9 patients (13 eyes) in the mixed CNV group. Subfoveal choroidal thickness (SFCT) was measured by enhanced scanning of confocal laser synchronous angiography system (Heidelberg Engineering, Germany). The best corrected visual acuity (BCVA) (logMAR) was recorded at corresponding times before and after treatment. The number of injections, the number of eyes requiring retreatment, and the recurrence rate of CNV were recorded at different times after treatment. SPSS 23.0 was used for statistical analysis. Results　The improved values of BCVA compared to the baseline in the type II CNV group at 1 week, 1 month and 2 months after treatment were higher than those of the type I CNV group and mixed CNV group, and the differences were statistically significant (all P<0.05). The improved values of BCVA compared to the baseline of the mixed CNV group at 6 months, 8 months and 12 months were lower than those of the type I CNV group and type II CNV group, and the differences were statistically significant (all P<0.05). After treatment, the SFCTs of patients in the three groups were significantly improved compared with the baseline (all P<0.05). The SFCT improved values compared to the baseline of patients in the mixed CNV group at 8 months and 12 months were lower than those of the type I CNV group and type II CNV group with significant differences (all P<0.05). During the follow-up period of 24 months, there were significant differences in the total number of drug injections among the three groups (P<0.05). The Student-Newman-Keuls q test showed that the number of drug injections in the type I CNV group and type II CNV group was significantly less than that in the mixed CNV group (both P<0.05). The differences in the rate of eyes requiring retreatment among the three groups were statistically significant (P<0.05). The mixed CNV group had more retreated eyes than the type I CNV group and the type II CNV group ［the 95% confidence interval of rate differences of eyes requiring retreatment were (0.051, 0.133) and (0.041, 0.142) respectively］. There was no significant difference in the recurrence rate among the three groups after therapy (P>0.05). Conclusion　Type II CNV group has a best response in the early stage of anti-VEGF treatment; type II CNV group and type I CNV group tend to have a similar response in the late stage of treatment. The mixed CNV group shows a poor response in the late stage of treatment.

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备注/Memo

备注/Memo:
国家自然科学基金资助(编号：82070983)
更新日期/Last Update: 2022-12-05