Abstract：
OBJECTIVE: To understand factors affecting visual prognosis and the number of intravitreal antivascular endothelial growth factor (anti-VEGF) injections needed to stabilize wet age-related macular degeneration (AMD).
METHODS: In this retrospective cohort, 119 treatment-naïve wet AMD patients were followed for two years. In patients with bilateral disease, the eye with worse best-corrected visual acuity (BCVA) or that received more intravitreal injections was recruited as the study eye. In all visits, BCVA was recorded, ophthalmological examination was performed including macular optical coherence tomography imaging. Twenty health status/lifestyle questions were asked to the patients via phone as potential risk factors. All patients received 3 loading doses of intravitreal bevacizumab injections and received repeat injections of aflibercept or ranibizumab when the eye had a new, active neovascular lesion.
RESULTS: Patients who took regular micronutrition had similar visual outcome and injection numbers compared to the ones who did not. Patients with bilateral disease needed less intravitreal injections compared to unilateral AMD patients (p = 0.016) and women on hormone replacement therapy (HRT) required less injections compared to the women who were not (p = 0.024). Female patients had a mean gain of 2.7 letters while male patients lost 3.8 letters (p = 0.038). Wet AMD started at an earlier age in smokers (p = 0.002). Patients with a better education level presented earlier with better BCVA (p = 0.037).
CONCLUSIONS: HRT and anti-VEGF injections to the fellow eye improved the prognosis of wet AMD, while male patients had slightly worse prognosis. Estrogen\'s protective effects and potential contribution in wet AMD needs further attention. Retrospectively registered: 2020/0622.
METHODS: In this retrospective cohort, 119 treatment-naïve wet AMD patients were followed for two years. In patients with bilateral disease, the eye with worse best-corrected visual acuity (BCVA) or that received more intravitreal injections was recruited as the study eye. In all visits, BCVA was recorded, ophthalmological examination was performed including macular optical coherence tomography imaging. Twenty health status/lifestyle questions were asked to the patients via phone as potential risk factors. All patients received 3 loading doses of intravitreal bevacizumab injections and received repeat injections of aflibercept or ranibizumab when the eye had a new, active neovascular lesion.
RESULTS: Patients who took regular micronutrition had similar visual outcome and injection numbers compared to the ones who did not. Patients with bilateral disease needed less intravitreal injections compared to unilateral AMD patients (p = 0.016) and women on hormone replacement therapy (HRT) required less injections compared to the women who were not (p = 0.024). Female patients had a mean gain of 2.7 letters while male patients lost 3.8 letters (p = 0.038). Wet AMD started at an earlier age in smokers (p = 0.002). Patients with a better education level presented earlier with better BCVA (p = 0.037).
CONCLUSIONS: HRT and anti-VEGF injections to the fellow eye improved the prognosis of wet AMD, while male patients had slightly worse prognosis. Estrogen\'s protective effects and potential contribution in wet AMD needs further attention. Retrospectively registered: 2020/0622.
摘要：
目的：了解影响视力预后的因素以及稳定湿性年龄相关性黄斑变性（AMD）所需的玻璃体内注射抗血管内皮生长因子（抗VEGF）的数量。
方法：在本回顾性队列中，119名治疗初期的湿性AMD患者随访两年。在双侧疾病患者中，纳入最佳矫正视力(BCVA)较差或接受更多玻璃体内注射的眼作为研究眼.在所有访问中,记录了BCVA，眼科检查包括黄斑光学相干断层扫描成像.通过电话向患者询问了20个健康状况/生活方式问题，作为潜在的危险因素。所有患者接受3个负荷剂量的玻璃体内贝伐单抗注射，并在眼睛出现新的，活动性新生血管病变。
结果：定期微量营养的患者与未定期微量营养的患者相比，其视觉结果和注射次数相似。与单侧AMD患者相比，双侧疾病患者需要更少的玻璃体内注射（p=0.016），与未接受激素替代疗法（HRT）的女性相比，女性需要更少的注射（p=0.024）。女性患者的平均增益为2.7个字母，而男性患者的平均增益为3.8个字母（p=0.038）。湿性AMD在吸烟者的年龄较早开始(p=0.002)。教育水平较高的患者较早出现较好的BCVA（p=0.037）。
结论：对眼注射HRT和抗VEGF可改善湿性AMD的预后，而男性患者预后稍差。雌激素在湿性AMD中的保护作用和潜在作用需要进一步关注。回顾性注册：2020/0622。
方法：在本回顾性队列中，119名治疗初期的湿性AMD患者随访两年。在双侧疾病患者中，纳入最佳矫正视力(BCVA)较差或接受更多玻璃体内注射的眼作为研究眼.在所有访问中,记录了BCVA，眼科检查包括黄斑光学相干断层扫描成像.通过电话向患者询问了20个健康状况/生活方式问题，作为潜在的危险因素。所有患者接受3个负荷剂量的玻璃体内贝伐单抗注射，并在眼睛出现新的，活动性新生血管病变。
结果：定期微量营养的患者与未定期微量营养的患者相比，其视觉结果和注射次数相似。与单侧AMD患者相比，双侧疾病患者需要更少的玻璃体内注射（p=0.016），与未接受激素替代疗法（HRT）的女性相比，女性需要更少的注射（p=0.024）。女性患者的平均增益为2.7个字母，而男性患者的平均增益为3.8个字母（p=0.038）。湿性AMD在吸烟者的年龄较早开始(p=0.002)。教育水平较高的患者较早出现较好的BCVA（p=0.037）。
结论：对眼注射HRT和抗VEGF可改善湿性AMD的预后，而男性患者预后稍差。雌激素在湿性AMD中的保护作用和潜在作用需要进一步关注。回顾性注册：2020/0622。
