抗VEGF药物治疗特发性脉络膜新生血管预后影响因素及预测模型构建

Prognostic factors and prediction model construction of idiopathic choroidal neovascularization treated with anti-vascular endothelial growth factor drugs

摘要:

目的：探讨抗血管内皮生长因子(VEGF)药物治疗特发性脉络膜新生血管预后影响因素并构建相关预测模型。

方法：回顾性纳入2020-01/2023-06于我院接受抗VEGF药物治疗特发性脉络膜新生血管患者57例57眼，根据治疗后病灶消退及复发情况分组； 对抗VEGF药物治疗特发性脉络膜新生血管病灶消退及新生血管复发的影响因素进行单因素分析。对抗VEGF药物治疗特发性脉络膜新生血管病灶消退及新生血管复发的影响因素进行多因素分析。构建抗VEGF药物治疗特发性脉络膜新生血管病灶消退的临床预测模型。

结果：患者抗VEGF药物治疗后病灶消退17眼(30%)，复发13眼(23%)。单因素分析结果显示，病程、基线最佳矫正视力水平及基线黄斑中心凹视网膜厚度均可能与抗VEGF药物治疗特发性脉络膜新生血管病灶消退及新生血管复发有关(均P<0.05)。Logistic多因素分析结果证实，病程、基线最佳矫正视力水平及基线黄斑中心凹视网膜厚度是抗VEGF药物治疗特发性脉络膜新生血管病灶消退的影响因素(均P<0.05)，而与抗VEGF药物治疗特发性脉络膜新生血管复发无关(均P>0.05)。利用回归模型的影响因素以及P值预测概率对抗VEGF药物治疗特发性脉络膜新生血管病灶消退进行预测，约登指数分别为83.00%、75.74%、45.47%、85.00%。

结论：抗VEGF药物治疗特发性脉络膜新生血管病灶消退与病程、基线最佳矫正视力水平及基线黄斑中心凹视网膜厚度密切相关，而复发风险尚未得到相应的影响因素； 利用以上3个因素构建的数据模型对于患者的抗VEGF药物治疗特发性脉络膜新生血管病灶消退预测显示出良好的效能。

Abstract:

AIM: To investigate the prognostic factors of idiopathic choroidal neovascularization treated with anti-vascular endothelial growth factor(VEGF)drugs and construct predictive model.

METHODS:A total of 57 patients(57 eyes)with idiopathic choroidal neovascularization who received the treatment of anti-VEGF in our hospital from January 2020 to June 2023 were retrospectively included and grouped according to regression or recurrence of the disease. Univariate and multivariate analysis was performed on the influencing factor of regression or recurrence of idiopathic choroidal neovascularization lesions treated with anti-VEGF drugs. Clinical prediction model was constructed for the regression of idiopathic choroidal neovascularization lesions treated with anti-VEGF drugs.

RESULTS:After treatment, the lesions disappeared in 17 eyes and recurred in 13 eyes, with incidence rates of 30% and 23%, respectively. The results of univariate analysis showed that the course of disease, baseline best corrected visual acuity, and baseline macular fovea retinal thickness may all be related to the regression or recurrence of idiopathic choroidal neovascularization lesions treated with anti-VEGF drugs(all P<0.05). Logistic multivariate analysis showed that the course of the disease, baseline best corrected visual acuity level, and baseline macular fovea retinal thickness may all be related to the regression of idiopathic choroidal neovascularization treated with anti-VEGF drugs(all P<0.05), while those factors were not related to the recurrence of idiopathic choroidal neovascularization treated with anti-VEGF drugs(all P>0.05). The influencing factors of the regression model and the P-value prediction probability were used to predict the regression of idiopathic choroidal neovascular lesions treated with anti-VEGF drugs, and the Youden index was 83.00%, 75.74%, 45.47% and 85.00%, respectively.

CONCLUSION:The regression of idiopathic choroidal neovascularization treated with anti-VEGF drugs was closely related to the course of disease, baseline best corrected visual acuity level and baseline macular foveal retinal thickness, while the risk of recurrence has not been determined by corresponding influencing factors. The data model constructed by the above three factors has shown good efficiency in predicting the regression of patients with idiopathic choroidal neovascularization lesions treated with anti-VEGF drugs.