抗血管内皮生长因子A药物治疗年龄相关性黄斑变性随访及再治疗的策略

Follow-up and retreatment strategies in the anti-vascular endothelial growth factor-A therapy for neovascularization of age-related macular degeneration

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。

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 AMD, 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.