研究目的
To evaluate the 5-year results obtained in clinical practice in the treatment of neovascular age-related macular degeneration (nAMD) with anti-VEGF agents.
研究成果
Anti-VEGF therapy in clinical practice leads to long-term visual stabilization in the majority of patients with nAMD, with maintained anatomical improvements such as reduced central macular thickness. Baseline visual acuity significantly influences outcomes, highlighting the importance of early detection and treatment.
研究不足
The study is a single-center retrospective analysis with variations in treatment regimens and anti-VEGF agents over time. Not all patients were treatment-na?ve, as 18% had prior photodynamic therapy. The population may not be fully representative of broader clinical practice, and the retrospective nature limits control over variables.
1：Experimental Design and Method Selection:
A retrospective study design was used to analyze long-term outcomes of nAMD treatment with anti-VEGF agents in clinical practice. Data were collected from patient charts over a 5-year follow-up period, including visual acuity (VA) measured with ETDRS charts and optical coherence tomography (OCT) parameters such as central macular thickness (CMT) and presence of intraretinal or subretinal fluid. Statistical analysis was performed using IBM SPSS Statistics for Windows version 20.
2：Sample Selection and Data Sources:
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2. Sample Selection and Data Sources: The study included patients with nAMD who initiated anti-VEGF treatment before October 2009 at the Department of Ophthalmology of Hospital de S?o Jo?o, Porto, Portugal, and were followed for at least 1 year. Exclusion criteria included baseline VA <10 ETDRS letters or advanced lesions with large areas of subfoveal fibrosis or atrophy. Data were sourced from patient medical records.
3：List of Experimental Equipment and Materials:
Anti-VEGF agents used were bevacizumab, ranibizumab, and aflibercept. OCT scans were obtained using the Stratus device (Carl Zeiss Meditec AG) until 2009 and the Spectralis HRA + OCT device (Heidelberg Engineering GmbH) more recently. Intravitreal injections were administered in the operating room under topical anesthesia.
4：Experimental Procedures and Operational Workflow:
Patients were treated with anti-VEGF agents using a pro re nata (PRN) regimen initially, with some transitioning to a 'treat and extend' approach. Injections were given at doses of 0.5 mg/50 μL for ranibizumab, 1.25 mg/50 μL for bevacizumab, and 2.0 mg/50 μL for aflibercept. VA and OCT assessments were conducted at baseline and at specified intervals over 5 years.
5：5 mg/50 μL for ranibizumab, 25 mg/50 μL for bevacizumab, and 0 mg/50 μL for aflibercept. VA and OCT assessments were conducted at baseline and at specified intervals over 5 years.
Data Analysis Methods:
5. Data Analysis Methods: Continuous variables were compared using t-tests for paired or independent samples, with Levene's test for homogeneity of variance. VA change was categorized as improved (gain ≥15 letters), stable (variation <15 letters), or decreased (loss ≥15 letters). Statistical significance was set at P<0.05.
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