Abrupt visual loss during anti-vascular endothelial growth factor treatment for type 3 neovascularization

作     者：Jae Hui Kim Young Suk Chang Jong Woo Kim Chul Gu Kim Dong Won Lee 

作者机构：Department of Ophthalmology Kim's Eye Hospital Konyang University College of Medicine Department of Ophthalmology Konyang University College of Medicine 

出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)

年 卷 期：2019年第12卷第3期

页      面：480-487页

核心收录：

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：age-related macular degeneration type 3 neovascularization retinal angiomatous proliferation hemorrhage tear in retinal pigment epithelium pigment epithelial detachment 

摘      要：AIM: To investigate the incidence of abrupt visual loss and its associated factors, during anti-vascular endothelial growth factor(VEGF) treatment for type 3 neovascularization.METHODS: This retrospective study included 137 eyes that were newly diagnosed with type 3 neovascularization. All eyes were treated with anti-VEGF therapy. Abrupt visual loss was defined as loss of 5 or more lines in best-corrected visual acuity(BCVA) in comparison to the previous visit. The incidence and timing of abrupt visual loss as well as the factors associated with it, were determined. In addition, the BCVA at the final follow-up was compared between the eyes with and those without abrupt visual loss.RESULTS: The mean follow-up period was 42.4±18.9 mo after diagnosis, and abrupt visual loss was noted in 22 eyes(16.1%) at a mean of 19.6±13.9 mo. Abrupt visual loss was found to be associated with subretinal hemorrhage in 11 eyes(50.0%), development of or increase in the height of pigment epithelial detachment with fluid in 8 eyes(36.4%), and tears in the retinal pigment epithelium in 3 eyes(13.6%). The logarithm of minimum angle of resolution(logMAR) mean BCVA at the final follow-up was 2.07±0.67(Snellen equivalents: 20/2349) and 1.00±0.55(20/200) in eyes with and without abrupt visual loss, respectively. BCVA was significantly worse in the eyes with abrupt visual loss(P0.001).CONCLUSION: Abrupt visual loss is noted in 16.1% of patients with type 3 neovascularization and is associated with poor visual outcome. Additional studies are needed to determine how abrupt visual loss can be prevented.