Wydanie specjalne czerw 2018
str. 26 - 31
Czynniki ryzyka chorób układu sercowo- -naczyniowego a efektywność terapii wysiękowej postaci zwyrodnienia plamki związanego z wiekiem inhibitorami czynnika wzrostu śródbłonka naczyń
Cardiovascular Risk Factors and the Response to Anti-Vascular Endothelial Growth Factor Therapy of Exudative Age-related Macular Degeneration
Joanna Łądkowska 1 , Barbara Krupa-Szafran 1 , Maciej Gawęcki 2,3 , Marek Szołkiewicz 4
1 Oddział Okulistyczny, Szpitale Pomorskie Sp. z o.o., Szpital Specjalistyczny w Wejherowie
Ordynator: dr n. med. Barbara Krupa-Szafran
2 Oddział Okulistyczny, Szpital Specjalistyczny w Chojnicach
Ordynator: dr n. med. Maciej Gawęcki
3 Poradnia Okulistyczna „Dobry Wzrok” w Gdańsku
Kierownik: dr n.med. Maciej Gawęcki
4 Oddział Kardiologii i Angiologii Interwencyjnej, Szpitale Pomorskie Sp. z o.o., Szpital
Specjalistyczny w Wejherowie
Ordynator: dr hab. n. med. Marek Szołkiewicz
Summary: Aim of the study: To evaluate the relationship between efficacy of anti-VEGF therapy in exudative form of age-related macular degeeration in relation to the presence of cardiovascular risk factors.
Material and Methods: 41 eyes with exudative form of age-related macular degeneration were included in the study (19 women and 22 men; average age 77 ± 7 years). Patients were treated with intravitreal injections of either ranibizumab (3 loading injections monthly than as needed) or aflibercept (fixed regime of 3 initial monthly injections followed by 4 bimonthly injections). Clinical effects were evaluated after 12 months of treatment. Best corrected visual acuity and retinal thickness (maximal, average and foveal) in optical coherence tomography were measured. Additionally the presence of the following cardiovacular risk factors was evaluated in every patient: age, gender, systemic arterial hypertension, diabetes, smoking, hypercholesterolemia, dyslipidemia, obesity, chronic renal dysfunction and family history of premature cardiovascular diseases. Response to the treatment was analyzed in relation to the presence of each of these factors.
Results: After 12 months of treatment statistically significant improvement in best corrected visual acuity was noted in the whole group (76.2 ± 14.3 vs 80.5 ± 14.8 ETDRS letters; p< 0.05) as well as significant morphological improvement: reduction of central retinal thickness maximal (614.6 ± 225 vs 526.4 ± 196.6 µm; p< 0.005), central retinal thickness average (299.1 ± 39.8 vs 271.0 ± 21.7 µm; p< 0.001) and central retinal thickness foveal (464.3 ± 244.4 vs 368.4 ± 181.7 µm; p< 0.005). Negative relationship between the presence of systemic hypertension and effects of anti-VEGF therapy was noted. No correlation was found between other studied risk factors and the efficacy of the therapy.
Conclusion: the study results confirm functional and morphological efficiency of anti-VEGF treatment in patients with age-related macular degeneration. Arterial hypertension significantly impairs the effects of the therapy.
Słowa kluczowe: zwyrodnienie plamki związane z wiekiem (AMD), terapia anty-VEGF, czynniki ryzyka.
Keywords: age-related macular degeneration (AMD), anti-VEGF therapy, risk factors.