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首页> 外文期刊>Investigative ophthalmology & visual science >Poor Responders to Bevacizumab Pharmacotherapy in Age-Related Macular Degeneration and in Diabetic Macular Edema Demonstrate Increased Risk for Obstructive Sleep Apnea
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Poor Responders to Bevacizumab Pharmacotherapy in Age-Related Macular Degeneration and in Diabetic Macular Edema Demonstrate Increased Risk for Obstructive Sleep Apnea

机译：在与年龄有关的黄斑变性和糖尿病性黄斑水肿中对贝伐单抗药物治疗的不良反应表明阻塞性睡眠呼吸暂停的风险增加

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Purpose: To investigate the risk of obstructive sleep apnea (OSA) in patients with exudative age-related macular degeneration (AMD) or diabetic macular edema (DME) who have poor response to anti-vascular endothelial growth factor (VEGF) therapy with bevacizumab (Avastin??). Methods: Two groups of patients were included in the case-control study - AMD group and DME group. AMD group included patients with a diagnosis of AMD who were further categorized into three sub-groups: non-exudative, exudative, or poor response exudative. DME group included patients with a diagnosis of non-proliferative diabetic retinopathy (NPDR) and clinically significant diabetic macular edema (CSDME). Patients were further categorized into three sub-groups based upon the number of intravitreal injections of bevacizumab received: 1 injection, 2 or more consecutive injections, and 3 or more consecutive injections. Patients in both groups were compared to age-matched controls. All patients completed the Berlin Questionnaire, a screening questionnaire for OSA, to assess their risk of OSA. The main outcome measure was the calculated risk of OSA for each group. Results: In the AMD group, of the 103 patients, 56 (54.37%) had non-exudative AMD and 47 (45.63%) had exudative AMD, of which 14 (29.79%) had poor response exudative AMD. The poor response exudative AMD group was at a significantly higher risk for OSA (p0.05) in comparison to all other groups. In the DME group, of the 30 patients with cystoid macular edema (CME) on optical coherence tomography (OCT) imaging, 4 (19%) received only 1 injection, 18 (81.82%) received 2 or more consecutive injections, and 16 (72.73%) received 3 or more consecutive injections. The risk of OSA increased significantly with increasing number of injections (p0.05). Conclusions: Patients with exudative AMD and DME who have poor response to therapy with intravitreal anti-VEGF therapy with bevacizumab have a significantly higher risk for OSA in comparison to age-matched controls. Poor responders to anti-VEGF therapy should be screened to assess their risk for OSA.
机译：目的：探讨贝伐单抗对抗血管内皮生长因子（VEGF）治疗反应较差的年龄相关性渗出性黄斑变性（AMD）或糖尿病性黄斑水肿（DME）的患者发生阻塞性睡眠呼吸暂停（OSA）的风险（阿瓦斯丁??）。方法：病例对照研究分为两组：AMD组和DME组。 AMD组包括诊断为AMD的患者，将其进一步分为三个亚组：非渗出性，渗出性或不良反应渗出性。 DME组包括诊断为非增生性糖尿病视网膜病变（NPDR）和临床上明显的糖尿病性黄斑水肿（CSDME）的患者。根据接受的贝伐单​​抗玻璃体内注射的次数将患者进一步分为三个亚组：1次注射，2次或更多次连续注射以及3次或更多次连续注射。将两组患者与年龄匹配的对照组进行比较。所有患者均完成了OSA筛查问卷柏林问卷，以评估其OSA风险。主要结局指标是每组OSA的计算风险。结果：在AMD组中，103例患者中有56例（54.37％）为非渗出性AMD，47例（45.63％）为渗出性AMD，其中14例（29.79％）有缓解性渗出性AMD。与所有其他组相比，反应不良的渗出性AMD组的OSA风险显着更高（p <0.05）。在DME组中，光学相干断层扫描（OCT）成像的30例囊状性黄斑水肿（CME）患者中，只有4例（19％）接受了1次注射，有18例（81.82％）接受了2次或更多次连续注射，而16例（ 72.73％）接受了3次或更多次连续注射。随着注射次数的增加，OSA的风险显着增加（p <0.05）。结论：与年龄匹配的对照组相比，对贝伐单抗玻璃体内抗VEGF治疗的反应较差的渗出性AMD和DME患者的OSA风险明显更高。应筛选抗VEGF治疗反应不良的患者，以评估其OSA风险。

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