Abstract:AIM:To understand the clinic effect of intravitreal anti-vascular endothelial growth factor(VEGF)drugs injection in the treatment of fundus disease in the real-world study(RWS).
METHODS: The clinical cases treated with anti-VEGF drugs in our department from September 2012 to June 2015 were enrolled in this study. Retrospective investigation was reviewed to the kinds of diseases, frequency, usage, efficacy, adverse reaction, and the effects on visual acuity, fundus and macular thickness which were treated with intravitreal anti-VEGF drugs injection.
RESULTS: In 305 patients(340 eyes)treated with anti-VEGF drugs, 53 patients(60 eyes, 17.6%)were wet age-related macular degeneration(AMD), polypoidal choroidal vasculopathy(PCV)16 cases(18 eyes, 5.3%), diabetic macular edema(DME)120 cases(134 eyes, 39.4%), branch retinal vein occlusion(BRVO)secondary macular edema 61 cases(68 eyes, 20.0%), central retinal vein occlusion(CRVO)secondary macular edema 29 cases(32 eyes, 9.4%), idiopathic choroidal neovascularization(ICNV)16 cases(18 eyes, 5.3%), high myopia with choroid neovascularization 4 cases(4 eyes, 1.2%), neovascular glaucoma 4 cases(4 eyes, 1.2%), retinal angiomatous proliferation(RAP)1 cases(1 eyes, 0.2%)and optic papillary neovascularization 1 cases(1 eyes, 0.2%). The minimum age was 16 years old, and the maximum age 90 years old. There were 247 cases(275 eyes, 80.9%)were treated with intravitreal ranibizumab injection, 58 cases(65 eyes, 19.1%)intravitreal conbercept injection. The time number of all patients accepted anti-VEGF drugs treatment was 465, with an average of 1.7 times per eye. Which, the "3 + PRN" treatment method in 98 patients(109 eyes, 32.1%), "1 + PRN" treatment in 207 patients(231 eyes, 67.9%). 69 cases(77 eyes, 22.6%)were used alone to receive anti-VEGF drugs therapy, 10 cases(11 eyes, 3.2%)combined with intravitreal triamcinolone injection(TA), 35 cases(39 eyes, 11.5%)combined with vitrectomy, 26 cases(29 eyes, 8.5%)combined with photodynamic treatment(PDT), 165 cases(184 eyes, 54.1%)combined with simple laser treatment. After anti-VEGF drug treatment, majority of patients' the best corrected visual acuity(BCVA), fundus and central macular thickness(CMT)were significantly improved, compared with the pre-treatment, the difference is significant(P<0.05). So that anti-VEGF drugs can effectively improve visual function and ocular fundus for fundus diseses. There were no serious adverse reactions except 3 patients appearling skin redness, itching, rash, 1 patient low low-grade fever and 1 patient acute cerebral infarction during the treatment.
CONCLUSION: Intravitreal anti-VEGF drugs injection can significantly improve the visual function and ocular fundus for patients with fundus diseases, but there are still some adverse events, which should be attached great importance to medical workers.