Офтальмохирургия. 2014; : 95-100
К ВОПРОСУ ОЦЕНКИ ЭФФЕКТИВНОСТИ АНТИ-VEGF-ТЕРАПИИ МАКУЛЯРНОГО ОТЕКА ПРИ ВМД
https://doi.org/undefinedАннотация
Цель. Повышение эффективности диагностики и лечения «влажной» формы ВМД путем динамической оценки функции макулярной области.
Материал и методы. 52 пациента (65 глаз) с «влажной» формой ВМД, которым проводилось интравитреальное введение Луцентиса (ИВВЛ): 1-я группа (n=20) – до 4 мес. после появления жалоб; 2-я группа (n=24) – в течение 4-12 мес., 3-я группа (n=22) – после 12 мес. Дополнительно до и после лечения всем пациентам проводился 3D-CTAG. Критерии: отношение объема потери поля зрения к холму зрения (ОПХЗ). Результаты. Через 1 мес. после ИВВЛ в 1-й группе ОПХЗ уменьшилось с 2,78±0,18 до 1,26±0,12; с 11,19±0,69 до 5,11±0,74 и с 35,33±3,10 до 17,34±1,07%, в % от 693000 [град2 %] для малых, средних и больших ХНВ соответственно (p<0,01), во 2-й группе – с 1,29±1,68 до 1,14±0,65; с 12,92±1,99 до 8,92±0,28 и с 23,79±13,36 до 13,65±3,65%, в % от 693000 [град2 %] для малых, средних и больших ХНВ соответственно (p<0,01). В 3-й группе ОПХЗ увеличилось с 12,79±1,2 до 20,16±8,32 и с 27,58±2,48 до 41,53±13,48%, в % от 693000 [град2 %] для средних и больших ХНВ соответственно (p<0,01).
Выводы. Раннее проведение анти-VEGF-терапии способствует уменьшению центральных скотом. При отсутствии признаков активности длительно существующей ХНВ ИВВЛ повышает риск снижения зрительных функций.
Список литературы
1. Богатырева Е.С., Милюткина С.О. Результаты скрининга пациентов с подозрением на глаукому и возрастную макулярную дегенерацию в проекте «Предвидеть – значит видеть» // Врач-аспирант – 2014. – № 1 (62). – С. 37-45.
2. Нероев В.В. Российское наблюдательное эпидемиологическое неинтервенционное исследование пациентов с влажной формой возрастной макулярной дегенерации // Российский офтальмол. журн. – 2011. – № 2. – С. 4-9.
3. Amsler M. L’examen qualitatif de la fonction maculaire // Ophthalmologica. – 1947. – Vol. 114. – P. 248-261.
4. Anderson D.H., Radeke M.J., Gallo N.B. et al. The pivotal role of the complement system in ageing and age-related macular degeneration: hypothesis re-visited // Prog. Retin. Eye Res. – 2010. – Vol. 29, № 2. – P. 95-112.
5. Bird A.C., Bressler N.M., Bressler S.B. et al. An international classification and grading system for age-related maculopathy and age-related macular degeneration. The international ARM Epidemiological Study Group // Surv. Opthalmol.: USA. – 1995. – Vol. 39, № 5. – P. 367-374.
6. Brown D.M., Kaiser P.K., Michels M. et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration // N. Engl. J. Med. – 2006. – Vol. 355. – P. 1432-1444.
7. Ferrara N., D’Amico L., Shams N. et al. Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age-related macular degeneration // Retina. – 2006. – Vol. 26. – P. 850-870.
8. Fink W., Sadun A. 3D Computer-automated Threshold Amsler Grid Test // J. Biomed Opt. – 2004. – Vol. 9, № 1. – P. 149-153.
9. Holz F.G., Pauleikhoff D., Spaid R.F., Bird A.C. (Eds.) Age-related macular degeneration. – Berlin, Heidelberg: Springer-Verlag, 2013. – 320 p.
10. Jivrajka R.V., Kim J.K., Fink W. et al. Quantitative analysis of central visual field defects in macular edema using threedimensional computer-automated threshold Amsler grid testing // Graefes Arch. Clin. Exp. Ophthalmol. – 2009. – Vol. 247, № 2. – P. 165-170.
11. Klein R., Klein B.E.K., Tomany S.C., Moss S.E. Ten-year incidence of age-related maculopathy and smoking and drinking. The Beaver Dam Eye Study // Am. J. Epidemiol. – 2002. – Vol. 156. – P. 589-598.
12. Klein R.J., Zeiss C., Chew E.Y. et al. Complement factor H polymorphism in age-related macular degeneration // Science. – 2005. – Vol. 308 (5720). – P. 385389.
13. Lin K., Fink W., Kamjoo S. et al. 3D Computer-automated Threshold Amsler Grid to quantify retinal deficits before and after standart treatment of wet age-related macular degeneration // Invest. Ophthalmol. Vis. Sci. – 2013. – P. 54. – E-Abstract 4642. ARVO. 2013.
14. Maxine Lipner. Третье измерение в диагностике ВМД // Eyeworld. Россия. – 2012. – Сент. – Т. 5, № 3. – С. 4.
15. Miller H., Miller B., Ryan S.J. Newly-formed subretinal vessels. Fine structure and fluorescein leakage // Invest. Ophthalmol. Vis. Sci. – 1986. – Vol. 27. – P. 204-213.
16. Mitchell P., Korobelnik J.F., Lanzetta P. et al. Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials // Br. J. Ophthalmol. – 2010. – Vol. 94. – P. 2-13.
17. Nazemi P.P., Fink W., Lim J.I., Sadun A.A. Scotomas of age-related macular degeneration detected and characterized by means of a novel three-dimensional computer-automated visual field test // Retina. – 2005. – Vol. 25. – P. 446-453.
18. Nordgaard C.L., Karunadharma P.P., Feng X. et al. Mitochondrial proteomics of the retinal pigment epithelium at progressive stages of age-related macular degeneration // Invest. Ophthalmol. Vis. Sci. – 2008. – Vol. 49, № 7. – P. 28482855.
19. Parravano M.C., Oddone F., Tedeschi M. et al. Retinal functional changes measured by microperimetry in neovascular age-related macular degeneration patients treated with ranibizumab // Retina. – 2009. – Vol. 29. – P. 329-334.
20. Robison C.D., Jivrajka R.V., Bababeygy S.R. et al. Distinguishing wet from dry age-related macular degeneration using threedimensional computer-automated threshold Amsler grid testing // Br. J. Ophthalmol. – 2011. – Vol. 95. – P. 1419-1423.
21. Rosenfeld P.J., Brown D.M., Heier J.S. et al. Ranibizumab for neovascular age-related macular degeneration // N. Engl. J. Med. – 2006. – Vol. 355. – P. 1419-1431.
22. Schmidt-Erfurth U., Eldem B., Guymer R. et al. Efficacy and safety of monthly versus quarterly ranibizumab treatment in neovascular age-related macular degeneration: the EXCITE study // Ophthalmology. – 2010. – Vol. 118. – P. 831-839.
23. Sparrow J.R., Boulton M. RPE lipofuscin and its role in retinal pathobiology // Exp. Eye Res. – 2005. – Vol. 80. – P. 595-606.
24. The Royal College of Ophthalmologists Age-related macular degeneration guidelines for management. – 2013. – 145 p.
25. Yuan X., Gu X., Crabb J.S. et al. Quantitative proteomics: comparison of the macular Bruch membrane/choroid complex from age-related macular degeneration and normal eyes // Mol. Cell. Proteomics. – 2010. – Vol. 9. – P. 1031-1046.
26. Zarbin M.A. Current concepts in the pathogenesis of age-related macular degeneration // Arch. Ophthalmol. – 2004. – Vol. 122, № 4. – P. 598-561.
Fyodorov Journal of Ophthalmic Surgery. 2014; : 95-100
THE EVALUATION ATTEMPTS IN ANTI-VEGF THERAPY OF AMD MACULAR EDEMA
https://doi.org/undefinedAbstract
Purpose. Improving the efficiency of diagnosis and treatment of the wet AMD by dynamic evaluation of macular function. Мaterial and methods. The study included 52 patients (65 eyes) with the wet AMD which underwent intravitreal injection of Ranibizumab. Duration of complaints: group 1 (n=20) – less than 4 months, group 2 (n=24) – 4-12 months, group 3 (n=22): more than 12 months. Additionally the 3D-CTAG was performed in all patients. Criteria: a relation of the visual field loss volume to the vision top (VLRH).
Results. In treatment 1 month after Ranibizumab the Group 1: VLRH increased from 2.78±0.18 to 1.26±0.12 insmall CNV, from 11.19±0.69 to 5.11±0.74 inmiddle CNV, 35.33±3.10 to 17.34±1.07% in % of 693000 [deg2%] in big CNV (p<0,01). Group 2: VLRH = 1.29±1.68 to 1.14±0.65 insmall CNV; 12.92±1.99 to 8.92±0.28 inmiddle CNV, 23.79±13.36 to 13.65±3.65 in% of 693000 [deg2%] in big CNV (p<0,01). Group 3: VLRH = 12.79±1.2 to 20.16±8.32 inmiddle CNV, 27.58±2.48 to 41.53±13.48% in % of 693000 [deg2%] in big CNV.
Conclusions. Early anti-VEGF therapy reduces scotomas in wet AMD patients but in a long-term inactive CNV it increases the risk of visual function reduction.
References
1. Bogatyreva E.S., Milyutkina S.O. Rezul'taty skrininga patsientov s podozreniem na glaukomu i vozrastnuyu makulyarnuyu degeneratsiyu v proekte «Predvidet' – znachit videt'» // Vrach-aspirant – 2014. – № 1 (62). – S. 37-45.
2. Neroev V.V. Rossiiskoe nablyudatel'noe epidemiologicheskoe neinterventsionnoe issledovanie patsientov s vlazhnoi formoi vozrastnoi makulyarnoi degeneratsii // Rossiiskii oftal'mol. zhurn. – 2011. – № 2. – S. 4-9.
3. Amsler M. L’examen qualitatif de la fonction maculaire // Ophthalmologica. – 1947. – Vol. 114. – P. 248-261.
4. Anderson D.H., Radeke M.J., Gallo N.B. et al. The pivotal role of the complement system in ageing and age-related macular degeneration: hypothesis re-visited // Prog. Retin. Eye Res. – 2010. – Vol. 29, № 2. – P. 95-112.
5. Bird A.C., Bressler N.M., Bressler S.B. et al. An international classification and grading system for age-related maculopathy and age-related macular degeneration. The international ARM Epidemiological Study Group // Surv. Opthalmol.: USA. – 1995. – Vol. 39, № 5. – P. 367-374.
6. Brown D.M., Kaiser P.K., Michels M. et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration // N. Engl. J. Med. – 2006. – Vol. 355. – P. 1432-1444.
7. Ferrara N., D’Amico L., Shams N. et al. Development of ranibizumab, an anti-vascular endothelial growth factor antigen binding fragment, as therapy for neovascular age-related macular degeneration // Retina. – 2006. – Vol. 26. – P. 850-870.
8. Fink W., Sadun A. 3D Computer-automated Threshold Amsler Grid Test // J. Biomed Opt. – 2004. – Vol. 9, № 1. – P. 149-153.
9. Holz F.G., Pauleikhoff D., Spaid R.F., Bird A.C. (Eds.) Age-related macular degeneration. – Berlin, Heidelberg: Springer-Verlag, 2013. – 320 p.
10. Jivrajka R.V., Kim J.K., Fink W. et al. Quantitative analysis of central visual field defects in macular edema using threedimensional computer-automated threshold Amsler grid testing // Graefes Arch. Clin. Exp. Ophthalmol. – 2009. – Vol. 247, № 2. – P. 165-170.
11. Klein R., Klein B.E.K., Tomany S.C., Moss S.E. Ten-year incidence of age-related maculopathy and smoking and drinking. The Beaver Dam Eye Study // Am. J. Epidemiol. – 2002. – Vol. 156. – P. 589-598.
12. Klein R.J., Zeiss C., Chew E.Y. et al. Complement factor H polymorphism in age-related macular degeneration // Science. – 2005. – Vol. 308 (5720). – P. 385389.
13. Lin K., Fink W., Kamjoo S. et al. 3D Computer-automated Threshold Amsler Grid to quantify retinal deficits before and after standart treatment of wet age-related macular degeneration // Invest. Ophthalmol. Vis. Sci. – 2013. – P. 54. – E-Abstract 4642. ARVO. 2013.
14. Maxine Lipner. Tret'e izmerenie v diagnostike VMD // Eyeworld. Rossiya. – 2012. – Sent. – T. 5, № 3. – S. 4.
15. Miller H., Miller B., Ryan S.J. Newly-formed subretinal vessels. Fine structure and fluorescein leakage // Invest. Ophthalmol. Vis. Sci. – 1986. – Vol. 27. – P. 204-213.
16. Mitchell P., Korobelnik J.F., Lanzetta P. et al. Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials // Br. J. Ophthalmol. – 2010. – Vol. 94. – P. 2-13.
17. Nazemi P.P., Fink W., Lim J.I., Sadun A.A. Scotomas of age-related macular degeneration detected and characterized by means of a novel three-dimensional computer-automated visual field test // Retina. – 2005. – Vol. 25. – P. 446-453.
18. Nordgaard C.L., Karunadharma P.P., Feng X. et al. Mitochondrial proteomics of the retinal pigment epithelium at progressive stages of age-related macular degeneration // Invest. Ophthalmol. Vis. Sci. – 2008. – Vol. 49, № 7. – P. 28482855.
19. Parravano M.C., Oddone F., Tedeschi M. et al. Retinal functional changes measured by microperimetry in neovascular age-related macular degeneration patients treated with ranibizumab // Retina. – 2009. – Vol. 29. – P. 329-334.
20. Robison C.D., Jivrajka R.V., Bababeygy S.R. et al. Distinguishing wet from dry age-related macular degeneration using threedimensional computer-automated threshold Amsler grid testing // Br. J. Ophthalmol. – 2011. – Vol. 95. – P. 1419-1423.
21. Rosenfeld P.J., Brown D.M., Heier J.S. et al. Ranibizumab for neovascular age-related macular degeneration // N. Engl. J. Med. – 2006. – Vol. 355. – P. 1419-1431.
22. Schmidt-Erfurth U., Eldem B., Guymer R. et al. Efficacy and safety of monthly versus quarterly ranibizumab treatment in neovascular age-related macular degeneration: the EXCITE study // Ophthalmology. – 2010. – Vol. 118. – P. 831-839.
23. Sparrow J.R., Boulton M. RPE lipofuscin and its role in retinal pathobiology // Exp. Eye Res. – 2005. – Vol. 80. – P. 595-606.
24. The Royal College of Ophthalmologists Age-related macular degeneration guidelines for management. – 2013. – 145 p.
25. Yuan X., Gu X., Crabb J.S. et al. Quantitative proteomics: comparison of the macular Bruch membrane/choroid complex from age-related macular degeneration and normal eyes // Mol. Cell. Proteomics. – 2010. – Vol. 9. – P. 1031-1046.
26. Zarbin M.A. Current concepts in the pathogenesis of age-related macular degeneration // Arch. Ophthalmol. – 2004. – Vol. 122, № 4. – P. 598-561.
