研究目的
To provide guidelines and recommendations for the diagnosis and treatment of choroidal neovascularization (CNV) in various retinal diseases beyond age-related macular degeneration (AMD), emphasizing the use of anti-VEGF therapy and other modalities.
研究成果
Anti-VEGF therapy with ranibizumab or aflibercept is recommended as the first-line treatment for active CNV in diseases other than AMD, based on superior efficacy compared to PDT. Diagnosis should involve comprehensive imaging, and treatment should be tailored to individual disease activity, with regular monitoring. Switching between VEGF inhibitors or discontinuing treatment may be necessary based on response. The guidelines emphasize the importance of accurate diagnosis and interdisciplinary care for underlying systemic conditions.
研究不足
The recommendations are based on available evidence, which may include studies with low evidence levels such as retrospective case series. Off-label use of some VEGF inhibitors (aflibercept and bevacizumab) is mentioned, which may have regulatory and safety implications. PDT is noted to have poorer results and should be used only in specific cases. Individual patient responses to therapy can vary, and treatment may not be effective in all cases, especially if visual acuity is very low or if there is atrophy/fibrosis.
1:Experimental Design and Method Selection:
The paper is a statement and guideline document based on literature review and expert consensus, not an experimental study. It summarizes findings from clinical trials and studies such as RADIANCE, MYRROR, and MINERVA, which are randomized controlled trials comparing treatments like ranibizumab, aflibercept, and photodynamic therapy for CNV in various conditions.
2:Sample Selection and Data Sources:
Data are derived from published studies involving patients with CNV secondary to conditions like high myopia, angioid streaks, central serous chorioretinopathy, uveitis, eye injuries, retinal dystrophies, idiopathic CNV, and subretinal tumors. Specific studies referenced include RADIANCE (n=277 patients with myopic CNV), MYRROR (n=122 patients with myopic CNV), and MINERVA (n=178 patients with CNV from other causes).
3:List of Experimental Equipment and Materials:
Equipment includes devices for best-corrected visual acuity testing, fundus examination, optical coherence tomography (OCT), and fluorescein angiography. Medications used are VEGF inhibitors (ranibizumab, aflibercept, bevacizumab) and verteporfin for photodynamic therapy.
4:Experimental Procedures and Operational Workflow:
For diagnosis, perform best-corrected visual acuity, fundus examination, OCT, and fluorescein angiography initially and at follow-ups. For treatment, administer intravitreal injections of VEGF inhibitors based on activity criteria (e.g., presence of subretinal fluid, increased retinal thickness), with monthly monitoring. PDT is used in exceptional cases.
5:Data Analysis Methods:
Analysis involves comparing visual acuity changes (measured in letters), central retinal thickness, and safety profiles from clinical trials, using statistical methods as per the referenced studies (e.g., randomized controlled trial designs).
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