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습성 연령관련황반변성에서 재발 시 주사하는 방식에서 지속주사 방식으로 교체 후의 임상결과

Clinical Outcomes after Switching from As-needed to Proactive Injections in the Neovascular Age-related Macular Degeneration

대한안과학회지 2020년 61권 6호 p.630 ~ 638
임수현 ( Lim Soo-Hyun ) - Konyang University College of Medicine Kim’s Eye Hospital Department of Ophthalmology

황재형 ( Hwang Jae-Hyung ) - Konyang University College of Medicine Kim’s Eye Hospital Department of Ophthalmology
김종우 ( Kim Jong-Woo ) - Konyang University College of Medicine Kim’s Eye Hospital Department of Ophthalmology
김철구 ( Kim Chul-Gu ) - Konyang University College of Medicine Kim’s Eye Hospital Department of Ophthalmology
이동원 ( Lee Dong-Won ) - Konyang University College of Medicine Kim’s Eye Hospital Department of Ophthalmology
김재휘 ( Kim Jae-Hui ) - Konyang University College of Medicine Kim’s Eye Hospital Department of Ophthalmology

Abstract


Purpose: To evaluate long-term clinical outcomes in patients with neovascular age-related macular degeneration (AMD) who were treated with an as-needed regimen but were switched to a proactive regimen during the course of treatment.

Methods: This retrospective study included 23 eyes with neovascular AMD which were initially treated with an as-needed regimen, but switched to a proactive regimen during the course of treatment. The duration of the as-needed phase was compared to that of the proactive phase. In addition, the number of injections per year and the degree of visual deterioration per year were compared between the two phases.

Results: The duration of the as-needed and proactive phases were 17.9 ± 8.3 months and 31.3 ± 13.2 months, respectively. The duration of the proactive phase was significantly longer (p < 0.001). The number of injections per year during the proactive phase (4.4 ± 1.0) was significantly more than that during the as-needed phase (2.8 ± 1.0) (p < 0.001). The degree of visual deterioration per year during the as-needed phase (0.08 ± 0.14) was slightly greater than that during the proactive phase (0.04 ± 0.08).
However, the difference was not statistically significant (p = 0.229).

Conclusions: The number of injections was higher after switching to the proactive regimen. However, the degree of visual deterioration was slightly lower than that noted during the as-needed phase. Further studies with a more controlled design are needed to determine more clearly the impact of switching treatment regimens on long-term clinical outcomes.

키워드

Age-related macular degeneration; Anti-vascular endothelial growth factor; As-needed; Choroidal neovascularization; Proactive
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