Miura Masahiro, Iwasaki Takuya, Goto Hiroshi
Department of Ophthalmology, Tokyo Medical University, Ibaraki Medical Center, Ami, Ibaraki, Japan ; Department of Ophthalmology, Tokyo Medical University, Nishi-Shinjuku, Tokyo, Japan.
Clin Ophthalmol. 2013;7:1591-5. doi: 10.2147/OPTH.S50634. Epub 2013 Aug 7.
To evaluate the effect of aflibercept treatment after developing ranibizumab tachyphylaxis for the treatment of polypoidal choroidal vasculopathy (PCV).
Ten eyes from ten patients with PCV who developed ranibizumab tachyphylaxis were reviewed. Tachyphylaxis was defined as when repeated intravitreal ranibizumab (IVR) resulted in a complete lack of response after initial treatment response. All treatments were converted to intravitreal aflibercept (IVA) after development of ranibizumab tachyphylaxis. Central retinal thickness (CRT) was compared at baseline, at complete resolution after IVR, at reactivation after IVR, at initial IVA, and at 4 and 12 weeks after initial IVA.
Mean number of IVR treatments before conversion to IVA was 11.3 (range 5-16). All eyes had positive therapeutic responses after conversion to IVA. Mean CRT at 4 and 12 weeks after initial IVA was significantly decreased from baseline initial IVA (P = 0.005).
Switching therapy to aflibercept is effective for patients with PCV who develop tachyphylaxis to ranibizumab.
评估在雷珠单抗出现快速耐受后，阿柏西普治疗息肉状脉络膜血管病变（PCV）的效果。
回顾了10例出现雷珠单抗快速耐受的PCV患者的10只眼。快速耐受定义为在最初治疗有效后，重复玻璃体内注射雷珠单抗（IVR）导致完全无反应。在出现雷珠单抗快速耐受后，所有治疗均转换为玻璃体内注射阿柏西普（IVA）。比较了基线时、IVR完全消退时、IVR再激活时、初次IVA时以及初次IVA后4周和12周时的中央视网膜厚度（CRT）。
转换为IVA前IVR治疗的平均次数为11.3次（范围5 - 16次）。转换为IVA后，所有眼睛均有阳性治疗反应。初次IVA后4周和12周时的平均CRT较基线初次IVA时显著降低（P = 0.005）。
对于对雷珠单抗产生快速耐受的PCV患者，转换为阿柏西普治疗有效。
