الملخص
Age-related macular degeneration(AMD)is a serious threat to the visual health of the elderly,and the dysfunction of retinal pigment epithelial cells(RPE)is a significant etiology risk.Aging process leads to RPE repli-cation senescence,and some environment factors like light exposure and cigarette exposure may lead to RPE stress premature aging,and the decreased lysosomal digestion ability of senescent RPE cells may lead to the accumulation of lipofuscin,triggering the occurrence of early AMD.A series of homeostatic imbalances in aging retina,such as cell senescence-renewal imbalance,oxidative stress-antioxidant imbalance,chronic inflammatory-anti-inflammatory imbalance,intestinal barrier and intestinal microbiota imbalance and pro-angiogenesis-antiangiogenic imbalance all contribute to the development of AMD.
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Objective:To find benefit of adaptive challenges in age-related macular degeneration (AMD) patients of long-term treatment in the challenge of vision decline, and provide new ideas for improving the quality of life of patients.Methods:It was a phenomenological study from qualitative research, selected by purpose sampling method and semi-structured interview which involved 20 AMD patients who received intravitreal treatment of drug in the Ophthalmology Department of Affiliated Hospital of Nantong University from January to March 2023.Two interviewees comprehensively read and analyzed the transcript of the interview and its meaning, subsequently Colaizzi seven-step analysis method was used to classify and encode the transcribed data.Results:Among 20 patients, there were 9 males and 11 females, aged 56-81 years old. Patients with AMD experience a sense of benefit in their long-term management of the condition, adapting to the challenges posed by declining strength, which could be summarized into four main themes: moderate sense of decision control, satisfactory social support, active self-management of the disease, and an improvement in quality of life.Conclusions:Patients with AMD experience a sense of disease-related benefit during the long-term management of visual acuity challenges. Healthcare professionals should guide patients to seek this benefit from adverse events, identify the adaptive challenges patients face, and leverage their adaptive leadership skills. Furthermore, offering multi-channel low vision rehabilitation services can assist patients in enhancing their adaptive capabilities, ultimately contributing to further improving their quality of life.
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Objective To investigate the effect of the HtrA serine peptidase 3(HTRA3)gene on choroidal neovascu-larization(CNV)and M2 macrophage polarization.Methods Fasting venous blood was collected from 30 patients with wet age-related macular degeneration(wAMD group)and 30 healthy subjects(normal group).The serum HTRA3 messen-ger ribonucleic acid(mRNA)level was detected by quantitative reverse transcription polymerase chain reaction(qRT-PCR).RF/6A cells were randomly divided into the control group,NC-sh group and HTRA3-sh group.Lentiviral vectors of NC-shRNA and HTRA3-shRNA were transfected into RF/6A cells in the NC-sh group and HTRA3-sh group by Lipo-fectamine2000.HTRA3 transfection was detected by qRT-PCR and Western blot.Then,the RF/6A cells were randomly di-vided into the N group,H group,H+NC-sh group and H+HTRA3-sh group.After cell transfection,RF/6A cells in the N group were cultured in a RPMI 1640 complete medium at a normoxia state,and cells in other groups were cultured in a RP-MI 1640 medium with 200 mmol·L-1 CoCl2 at a hypoxia state.Tubule formation was measured by Matrigel.The C57BL/6J mice were divided into the control group,CNV group,CNV+NC-sh group and CNV+HTRA3-sh group,with 12 mice in each group.Mice in the control group were unmodeled mice,and mice in the other groups were laser-induced CNV model mice.NC-shRNA and HTRA3-shRNA lentiviral vectors with a titer of 1 × 1011 TU·mL-1 were administered to mice in the CNV+NC-sh group and CNV+HTRA3-sh group via intravitreal injection.Mice in the control group and CNV group were in-jected with phosphate buffered saline.After 7 days of treatment,the mice were examined by fundus fluorescein angiogra-phy,and the eyeballs received hematoxylin & eosin staining.The mRNA levels of HTRA3,chitinase-like protein 3(Ym-1),arginase 1(Arg-1),inducible nitric oxide synthase(iNOS),cyclooxygenase-2(COX-2)and vascular endothelial growth factor(VEGF)in RF/6A cells or choroidal tissues were detected by qRT-PCR.The protein expression levels of HTRA3,VEGF and nuclear factor kappa B(NF-κB)p65 in RF/6A cells or choroidal tissues were detected by Western blot.Re-sults Compared with the normal group,serum HTRA3 mRNA level of patients in the wAMD group increased(t=11.804,P＜0.001).Compared with the control group and NC-sh group,the expressions of HTRA3 mRNA and protein in RF/6A cells in the HTRA3-sh group decreased(all P＜0.05).Compared with the N group,the number of closed lumen and the mRNA and protein expressions of HTRA3 and VEGF in RF/6A cells in the H group increased(all P＜0.05).Compared with the H+NC-sh group,the number of closed lumen and the mRNA and protein expressions of HTRA3 and VEGF decreased in RF/6A cells in the H+HTRA3-sh group(all P＜0.05).Compared with the control group,the mRNA and protein expression levels of HTRA3 increased,the relative fluorescence intensity of CNV increased,the mRNA levels of Ym-1 and Arg-1 in-creased,the iNOS and COX-2 mRNA levels decreased,and the NF-κB p65 protein expression level increased in mice of the CNV group(all P＜0.05).Compared with the CNV+NC-sh group,the mRNA and protein expression levels of HTRA3 de-creased,the relative fluorescence intensity of CNV decreased,the mRNA levels of Ym-1 and Arg-1 decreased,the mRNA levels of iNOS and COX-2 increased,and the NF-κB p65 protein expression level decreased in mice of the CNV+HTRA3-sh group(all P＜0.05).Conclusion Down-regulation of HTRA3 can inhibit the formation of CNV and the polarization of M2 macrophages.HTRA3 may be an important potential target for the prevention and treatment of wAMD.
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Dry age-related macular degeneration(AMD)is a degenerative disease affecting the macular region of the retina,and aging changes in retinal and choroidal tissues are an important factor in AMD pathogenesis.Cell aging is an irre-versible state of cell cycle arrest triggered by certain physiological processes or stressful injury,affecting a variety of physi-ological and pathological processes.An increasing number of studies have shown that cell aging plays an essential role in the occurrence and development of AMD.This paper reviews the mechanisms of cell aging and its relationship with dry AMD,aiming to provide new ideas for the treatment of dry AMD.
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Geographic atrophy(GA)is an intermediate and advanced stage of age-related macular degeneration(ARMD). Due to the complex pathogenesis of GA, there are no effective treatments at present, and eventually patients will lose central vision. Studies have shown that excessive activation of the complement system is closely related to the occurrence and progression of GA. This review will offer a summary of the clinical features, pathogenesis, the role of complement system in the pathology and the treatment progress of GA.
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AIM: To investigate the protective effect of Jianpi Bushen Yishi Formula on dry age-related macular degeneration(dARMD)induced by sodium iodate in mice and its mechanism.METHODS: A total of 27 SPF male C57BL/6 mice were randomly divided into blank, model and traditional Chinese medicine groups, with 9 in each group, the structure and morphology of the retina were observed by Hematoxylin-Ehong(HE)staining, and the intracellular reactive oxygen species(ROS)in the retina were observed by fluorescence staining with dihydroethidium(DHE). In addition, malondialdehyde(MDA)and superoxide dismutase(SOD)expression levels in mouse retina were detected by biochemical kit, and expression levels of silent information regulator type 1(SIRT1)and peroxisome proliferator-activated receptor-γ coactivator 1-α(PGC-1α)protein in mouse retina were detected by Western blot.RESULTS: Retinal structure and morphology of the model group showed a slight or mild decrease in the number of cells in the outer nuclear layer, a localized thinning of the outer nuclear layer, an inconspicuous demarcation between the outer and outer membranes, a slight or mild swelling of retinal pigment epithelial cells, and a slight or mild disturbance in the arrangement of retinal cells; while retinal pigment epithelial cells and photoreceptor layers in the traditional Chinese medicine group were significantly improved. DHE staining fluorescence results showed that the ROS level in the model group was significantly higher than that in the blank group at 14 d after modeling(P<0.01); the ROS level in the traditional Chinese medicine group was significantly lower than that in the model group(P<0.001). ELISA showed that the SOD level of the model group was significantly lower than that of the blank group at 14 d after modeling(P<0.01), and the MDA level was significantly increased(P<0.01)in the model group compared with the blank group; the SOD level was significantly higher(P<0.01), and the MDA level was significantly lower(P<0.01)in the traditional Chinese medicine group compared with the model group. Western blot results showed that the expression of SIRT1 and PGC-1α in the model group was significantly lower compared with that in the blank group(P<0.01), and the expression of SIRT1 and PGC-1α in the traditional Chinese medicine group was significantly higher compared with that in the model group at 7 and 14 d after modeling(P<0.01).CONCLUSION: The Chinese herbal medicine, which strengthens the spleen, tonifies the kidney and benefits the eyesight, can improve the oxidative stress state of the retina induced by sodium iodate in mice and reduce the damage to the retinal tissues, which may exert the anti-oxidative stress effect through the PGC-1α/SIRT1 signaling pathway.
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Age-related macular degeneration(ARMD)is the leading cause of blindness in the elderly. Studies have shown that the regulation disorder of extracellular matrix(ECM)is one of the important characteristics of ARMD, and its damage can be sustained throughout the disease course. Additionally, various cell types participate in the formation and abnormal deposition of ECM under the control of multiple signals. Subsequently, they transmit signals that regulate adhesion, migration, proliferation, apoptosis, survival or differentiation, which lead to the destruction of the retinal and choroidal microenvironment, immune dysfunction, infiltrative inflammatory cell differentiation, neovascularization and epithelial mesenchymal transformation, and ultimately lead to subretinal fibrosis, scarring and severe visual impairment in advanced ARMD. Therefore, increasing attention has been paid to the role of ECM in ARMD in recent years. This article reviews the relationship between retinal ECM and ARMD and the role between ECM and various types of cells in ARMD, hoping to provide guidance for the research direction of ARMD treatment.
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Objective@#To investigate the factors affecting macular degeneration (MD) in middle-aged and elderly populations, so as to provide the reference for prevention and treatment of MD.@*Methods@#People at ages of 50 years and older who were admitted to ophthalmology department of Hangzhou First People's Hospital and received MD screening were selected as the study subjects. General information including age, gender, eye-using habits and family history of MD were collected by questionnaire surveys. MD was diagnosed by ophthalmological examination, and the prevalence of MD in middle-aged and elderly people was analyzed. A multivariable logistic regression model was used to identify the influencing factors of MD.@*Results@#A total of 2 832 people were investigated, including 1 527 males (53.92%) and 1 305 females (46.08%), and 1 878 people (66.31%) aged 70 years and older. There were 498 people (17.58%) with good eye-using habits, 1 180 (41.67%) with general eye-using habits and 1 154 (40.75%) with poor eye-using habits. There were 1 817 people with family history of MD (64.16%). Multivariable logistic regression analysis showed that people at ages of 70 years and older (OR=2.815, 95%CI: 1.350-5.871), with poor eye-using habits (OR=2.354, 95%CI: 1.373-4.035), with family history of MD (OR=2.782, 95%CI: 1.138-6.799), with cataract (OR=2.593, 95%CI: 1.157-5.815) and with visual central defect (OR=2.601, 95%CI: 1.252-5.404) had a higher risk of MD.@*Conclusion@#Age, eye-using habits, family history of MD, cataract and visual central defect are influencing factors for MD in middle-aged and elderly populations.
الملخص
Age-related macular degeneration(ARMD)is a neurodegenerative disease associated with oxidative stress. It is characterized by progressive death of photoreceptors and retinal pigment epithelium(RPE), and is one of the leading causes of irreversible loss of central vision in patients over the age of 65 years old. MicroRNA(miRNA)is a class of regulatory short-chain non-coding RNA that can bind and inhibit multiple gene targets in the same biological pathway. This unique property makes microRNA an ideal target for exploring the pathogenesis, diagnosis and treatment of non-exudative ARMD. Previous studies have found that the pathogenesis of non-exudative ARMD involves age, genetics, environment, oxidative stress, lipid metabolism, autophagy and immunity. However, the exact mechanisms have not been fully clarified. As biomarkers of non-exudative ARMD, miRNA play a role in oxidative stress and lipid metabolism. This article summarizes the role of various miRNA in targeting Nrf2 and HIF-1α to inhibit hypoxia-related angiogenesis signaling, thereby affecting oxidative stress. Additionally, miRNA regulate lipid uptake and the expression of ABCA1 in RPE and macrophages, thereby influencing lipid metabolism. This deepens the understanding of the role of miRNA in oxidative stress and lipid metabolism in non-exudative ARMD, and provides directions for further improving the understanding of the pathogenesis and prevention of non-exudative ARMD.
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Wet age-related macular degeneration(wARMD)emerges as a primary contributor to irreversible vision impairment in the aging demographic. In clinical practice, anti-vascular endothelial growth factor(VEGF)therapies exhibit pronounced success in managing wARMD. However, in the actual clinical application, there are significant individual differences in the prognosis of anti-VEGF drug therapy, and some patients show poor response to the treatment, which may be related to the morphological differences of retinal layers in macular area, genetics, systemic conditions and other factors. It will help develop a more rational and individualized treatment plan to judge the prognosis of patients according to their different clinical manifestations in advance, so as to reduce overtreatment and the risk of retinal damage. In recent years, most studies on treatment response mainly focus on fundus morphology, genetics and so on. In this study, the relevant factors affecting adverse response to wARMD were reviewed, aiming to provide with more accurate treatment and prognostic monitoring programs for clinicians.
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N6-methyladenosine(m6A), the most common, abundant, and conserved RNA modification in eukaryotic cells, regulates RNA splicing, stability, output, degradation and translation through m6A methyltransferase, m6A demethylase, and m6A methylated binding proteins. Recent studies have found that abnormal m6A methylation may mediate a variety of pathological processes in eyes and participate in the occurrence and development of metabolic, inflammatory, degenerative ocular diseases and ocular tumors, such as diabetic retinopathy, cataract, age-related macular degeneration and uveal melanoma. This review aims to summarize the roles of m6A methylation modification in ocular cells and ocular diseases, elucidate the potential molecular mechanisms of m6A methylation in ocular diseases, so as to encourage innovative approaches in the treatment of these ocular diseases.
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AIM: To evaluate the clinical efficacy of Mongolian medicine Mingmu-11 Pills combined with conbercept in the treatment of wet age-related macular degeneration(wARMD).METHODS: Prospective study. All cases in this study were wARMD patients(72 cases, 72 eyes)admitted to the Ophthalmology Department of Affiliated Hospital of Inner Mongolia University from November 2020 to December 2021. They were randomly divided into a combined treatment group and a control group, each with 36 eyes, and the control group received intravitreal injection of conbercept 0.05 mL for 3 consecutive months. The combined treatment group was given Mingmu-11 Pills twice a day after surgery, with 3 wk as a course of treatment, a total of 3 courses, and the control group was not given Mongolian medicine treatment. The best corrected visual acuity(BCVA), changes in central macular thickness(CMT)in the macular area, and changes in N1, P1 wave amplitude density and latency were observed after treatment in both groups.RESULTS:The BCVA(letter number)of the two groups were improved(P<0.05), and the CMT were decreased(P<0.05). The improvement of BCVA(letter number)in the combined treatment group was better than that in the control group at 3 mo(17.42±3.29 vs 14.61±3.14, P<0.001)and 5 mo(19.75±3.25 vs 16.81±2.77, P<0.001)after treatment; compared with the control group, CMT of the combined treatment group was thinner than that of the control group at 3 mo(304.58±53.34 vs 351.94±52.99 μm, P<0.001)and 5 mo(274.17±62.26 vs 321.78±63.22 μm, P<0.05)after treatment. The amplitude density of N1 and P1 wave in mfERG in both groups at 3 mo after treatment was higher than that before treatment(P<0.05), and r1-r3 latency of P1 wave was shorter than that before treatment(P<0.05), with no differences in the r1-r3 latency of N1 wave(P>0.05). In addition, the amplitude density of N1 and P1 wave in the combined treatment group was higher than that in the control group at 3 mo after treatment(P<0.05), the latency of P1 wave in the treatment group was significantly shorter than that in the control group(P<0.05), and there was no significant difference in the latency of N1 wave between the two groups(P>0.05).CONCLUSIONS:Mingmu-11 Pills combined with intravitreal injection of conbercept in the treatment of wARMD has obvious efficacy in improving vision and reducing macular edema.
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Charles Bonnet syndrome(CBS)refers to hallucinations resulting from visual pathway damage in individuals without neuropsychiatric disorders. CBS patients typically have insight into the unreality of their hallucinations, and the disorder may be episodic, periodic, or chronic. The condition's prevalence varies from 0.4% to 30% due to the absence of agreed diagnostic criteria for CBS and some patients' reluctance to acknowledge hallucinations. Massive studies have demonstrated an association between CBS and ocular diseases, such as age-related macular degeneration and glaucoma. Additionally, there have been reports of CBS occurring after ophthalmic surgery or medication. Therefore, clinicians should be vigilant in diagnosing CBS promptly and reassuring patients. There is a lack of literature on CBS in ophthalmology, and further research is needed to explore its pathogenesis and diagnostic and therapeutic options. This article reviews some of the studies related to CBS in recent years.
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With the aging of the population in modern society, the incidence of age-related diseases increases gradually, especially the age-related macular degeneration (AMD). Despite advances in treatment in recent years, AMD remains one of the leading causes of blindness and visual impairment in the elderly.At present, people tend to think that AMD is caused by the combination of aging and inflammation, which also contribute to the occurrence and development of many other age-related diseases.Although more studies have focused on the role of inflammation in AMD, aging, as an important correlate, is also deserves in-depth investigation.This article reviewed the close relationship between substance accumulation, abnormal phagocytosis, abnormal mitochondrial function and oxidative stress damage caused by aging and the occurrence and development of AMD, with a view to improving clinicians' knowledge of AMD.
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Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly worldwide and is characterized by degeneration of the photoreceptor, retinal pigment epithelium, Bruch membrane and choriocapillaris complex.Impairment of RPE cell function is an early and critical event in the molecular pathways leading to clinically relevant AMD changes.Programmed cell death (PCD) plays an important role in response to stress and regulation of homeostasis and disease.In recent years, multiple studies have shown that apoptosis, pyroptosis, necroptosis and ferroptosis are likely involved in RPE cell PCD and correlate with the onset and development of AMD.There may be interaction or synergy between the various death pathways.This article reviewed the pathogenic mechanism of apoptosis, pyroptosis, necroptosis and ferroptosis in retinal pigment epithelial cell and their research progress in AMD, which might provide new approaches for the prevention and treatment of AMD.
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Angiogenesis is a key step involving physiological and pathological processes, and pro/antiangiogenic factors are involved in angiogenesis throughout. Melatonin is a product synthesized by the pineal gland of the human brain and acts in various systems of the body. This article briefly describes the wide range of biological roles and physiological functions of melatonin, and summarizes that melatonin regulates pro-/anti-angiogenic factors(e.g., vascular endothelial growth factor/matrix metalloproteinase)under different conditions and is involved in angiogenesis in fundus diseases(e.g., age-related macular degeneration, diabetic retinopathy, and central serous choroioretinopathy); in addition, it also summarizes that melatonin regulates various cytokines, inflammatory factors and signaling pathways to produce anti-inflammatory, antioxidant and immune responses in fundus diseases, and thus obtaining the application and potential treatment of melatonin in fundus vascular diseases, with a view to providing new ideas and therapeutic targets for the treatment of fundus diseases.
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Age-related macular degeneration(ARMD)is one of the leading causes of irreversible blindness in the elderly. Anti-vascular endothelial growth factor(VEGF)drugs have become the first-line treatment for neovascular ARMD, which has greatly changed the prognosis. However, dry ARMD still lacks effective treatment means, focusing on prevention. At present, several clinical treatment methods are being explored, including antioxidant therapy, complement therapy, neuroprotective therapy, gene therapy, etc. This review mainly summarizes the existing clinical trials and their progress on the treatment of dry ARMD, in order to provide future prospects for the treatment of dry ARMD. A number of clinical trials have already produced promising results for the treatment of dry ARMD, and it is believed that more and more clinical trials will be successful in the near future to provide more effective treatments for patients with dry ARMD.
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Ocular diseases pose a significant challenge to global health. The field of metabolomics, which involves the systematic identification and quantification of metabolites within a biological system, has emerged as a promising research approach for unraveling disease mechanisms and discovering novel biomarkers. Through its application, metabolomics has yielded valuable knowledge pertaining to the initiation and advancement of various ocular diseases. This review presents an overview of metabolomics and examines recent research progess in four ocular diseases, specifically diabetic retinopathy, age-related macular degeneration, glaucoma, and dry eye, summarizing potential biomarkers and metabolic pathways associated with these diseases. Additionally, this review offers insights into the future prospects of utilizing metabolomics for the management and treatment of ocular diseases.
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ABSTRACT Objective: To determine the prevalence of ocular alterations in patients diagnosed with dengue, admitted to a reference center for infectious and parasitic diseases in Manaus (AM), Brazil. Methods: This was an observational, analytical, and prospective case series study with 33 patients admitted to the hospital with positive clinical pathology tests during a 90-day period of a dengue epidemic in 2011. The investigations included measurement of visual acuity, macular assessment with Amsler grid test, fundus biomicroscopy, retinography and optical coherence tomography. Results: The average age of the patients was 35.48 years (minimum age 17 years and maximum 69 years). The main symptoms reported were blurred vision, followed by retro-ocular pain, photopsia, halos, foreign bodies, scotoma, double vision, and floaters. Visual acuity ranged from 20/20 to 20/40 (median 20/30). Macular assessment with Amsler Grid Test was unsatisfactory in three patients. The most common retinal findings were perimacular edema, macular edema, retinal hemorrhage, vasculitis, and changes in the retinal pigment epithelium. Optical coherence tomography showed retinal edema in 16 patients (51.51%). Conclusions: In all cases, the disease was self-limiting and resolved spontaneously without treatment. Therefore, this study confirms that ocular manifestations in dengue fever are varied and frequent.
RESUMO Objetivo: Determinar a prevalência de alterações oculares em pacientes com diagnóstico de dengue, internados em um centro de referência para doenças infecciosas e parasitárias em Manaus (AM), Brasil. Métodos: Estudo observacional, analítico e prospectivo de série de casos de 33 pacientes admitidos no hospital com exames de patologia clínica positivos durante um período de 90 dias de uma epidemia de dengue em 2011. As investigações incluíram medida da acuidade visual, avaliação macular com tela de Amsler, biomicroscopia de fundo de olho, retinografia e tomografia de coerência ótica. Resultados: A idade média dos pacientes foi de 35,48 anos (idade mínima de 17 anos e máxima de 69 anos). Os principais sintomas relatados foram visão turva, seguida de dor retro-ocular, fotopsia, halos, corpos estranhos, escotoma, visão dupla e moscas volantes. A acuidade visual variou entre 20/20 e 20/40 (mediana 20/30). A avaliação macular com a tela de Amsler foi insatisfatória em três doentes. Os achados retinianos mais comuns foram edema perimacular, edema macular, hemorragia retiniana, vasculite e alterações no epitélio pigmentar da retina. A tomografia de coerência óptica mostrou edema da retina em 16 doentes (51,51%). Conclusões: Em todos os casos, a doença foi autolimitada e resolveu-se espontaneamente sem tratamento. Este estudo confirma, portanto, que as manifestações oculares da dengue são variadas e frequentes.
الموضوعات
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Retinal Diseases/diagnosis , Retinal Diseases/etiology , Dengue/complications , Dengue/diagnosis , Macula Lutea/pathology , Brazil , Visual Acuity , Prospective Studies , Dengue/blood , Dengue Virus/isolation & purification , Tomography, Optical Coherence , Visual Field Tests , Observational Study , Slit Lamp Microscopyالملخص
ABSTRACT Objective: To characterize the effectiveness of anti-vascular endothelial growth factor drugs in exudative age-related macular degeneration. Methods: Retrospective longitudinal study of 54 patients with age-related macular degeneration receiving bevacizumab or aflibercept. Demographic data, visual acuity, and central retinal thickness measurements were collected. Improvement/stability of visual acuity and reduction in retinal thickness configured satisfactory responses. Results: Among the 60 eyes studied, there was no difference (p = 0.262) in satisfactory response when using bevacizumab (48.5%) or aflibercept (63.0%). Snellen's visual acuity, letter gain, and retinal thickness showed improvement or maintenance in 55.0%, 32.8%, and 78.3% of cases, respectively. The percentage of improvement/maintenance was higher in eyes with an initial visual acuity of < Snellen 20/400 (70.0% versus 40.0%; p = 0.002). Conclusion: A higher percentage of improvement/stabilization of visual acuity and macular thickness was observed in patients with age-related macular degeneration, with better response in patients with visual acuity worse than Snellen 20/400.
RESUMO Objetivo: Caracterizar a efetividade de medicamentos antifactor de crescimento endotelial vascular na degeneração macular relacionada à idade exsudativa. Métodos: Estudo longitudinal retrospectivo em 54 pacientes com degeneração macular relacionada à idade que usaram bevacizumab ou aflibercept. Foram coletados dados demográficos, da acuidade visual e da espessura central da retina. Melhora/estabilidade da acuidade visual e redução da espessura configuraram respostas satisfatórias. Resultados: Entre 60 olhos estudados, não houve diferença (p = 0,262) de acordo com o uso de bevacizumab (48,5%) ou aflibercept (63,0%). Acuidade visual segundo Snellen, ganho de letras e espessura retiniana demonstraram melhora ou estabilidade em 55,0%, 32,8% e 78,3% dos casos, respectivamente. Entre os olhos com acuidade visual inicial < 20/400, o percentual de melhora/estabilidade foi superior (70,0% versus 40,0%; p = 0,002). Conclusão: Em pacientes com degeneração macular relacionada à idade, foi percebida uma maior proporção de melhora ou estabilização da acuidade visual e espessura macular, com melhor resposta entre os pacientes com visão pior que 20/400.