CAJ | 학술논문

湿性年龄相关性黄斑变性(AMD)是55岁以上人群致盲的主要原因之一.抗血管内皮生长因子A(VEGF-A)眼内注射能有效治疗湿性AMD的新生血管并改善视力,但长期随访和再治疗是保持已获得视力的关键.目前,国际上眼科界基于患者的视力、光学相干断层扫描(OCT)、眼底和荧光素眼底血管造影(FFA)检查的变化制定的再治疗和随访策略较多,但尚未达成共识.中国AMD患者的构成情况、就诊习惯和医疗资源分布等与国外均有较大的差异.经对玻璃体内注射抗新生血管药物治疗湿性AMD的随访建议和再治疗标准进行分析,建议应该规范抗VEGF-A治疗策略,达到维持长期治疗效果、尽量减少随访治疗次数和医疗费用的目标,认为提出基于OCT为指导的个体化随访治疗方案应是今后的发展方向.
습성년령상관성황반변성(AMD)시55세이상인군치맹적주요원인지일.항혈관내피생장인자A(VEGF-A)안내주사능유효치료습성AMD적신생혈관병개선시력,단장기수방화재치료시보지이획득시력적관건.목전,국제상안과계기우환자적시력、광학상간단층소묘(OCT)、안저화형광소안저혈관조영(FFA)검사적변화제정적재치료화수방책략교다,단상미체성공식.중국AMD환자적구성정황、취진습관화의료자원분포등여국외균유교대적차이.경대파리체내주사항신생혈관약물치료습성AMD적수방건의화재치료표준진행분석,건의응해규범항VEGF-A치료책략,체도유지장기치료효과、진량감소수방치료차수화의료비용적목표,인위제출기우OCT위지도적개체화수방치료방안응시금후적발전방향.
Wet age-related macular degeneration (AMD) is one of major causes of blindness in elder people.Intraocular injection of anti-vascular endothelial growth factor (VEGF) -A regimen has made big breakthrough for the treatment on choroidal neovascularization of wet AM D,while long-term follow-up and necessary retreatments are the key issues to remain obtained visual acuity.Multiple strategies of wet AMD have been used in following-up and retreating based on the visual acuity,optical coherence tomography (OCT),ophthalmoscope and fluorescein fundus angiography (FFA) in abroad.However,there also are major differences in the patient' s composition,treatment habits and distribution of medical sources in China from Western.So we suggest to standardize the follow-up and retreatment strategies about intravitreal injection of VEGF-A for wet AMD as to achieve a better effectiveness.OCT-guided individual follow-up and retreatment strategies should be very helpful for maintaining a long-term efficacy,minimizing the treatment time and reducing medical cost.