Fauser Sascha, Schwabecker Viktoria, Muether Philipp S
Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.
Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.
Am J Ophthalmol. 2014 Sep;158(3):532-6. doi: 10.1016/j.ajo.2014.05.025. Epub 2014 May 28.
To determine the duration of suppression of aqueous humor concentrations of vascular endothelial growth factor (VEGF) in eyes with neovascular age-related macular degeneration (AMD) treated with aflibercept.
Nonrandomized prospective clinical study.
Twenty-seven eyes of 27 neovascular AMD patients receiving intravitreal aflibercept injections on a pro re nata regimen driven by spectral-domain optical coherence tomography (SD OCT) were included in this study. A total of 132 aqueous humor specimens were collected before intravitreal aflibercept injections and their VEGF-A concentrations assayed by multiplex bead analysis.
Mean aqueous humor VEGF concentrations before treatment initiation were 90.6 ± 37.1 pg/mL (range 23.4-190.3 pg/mL). Intravitreal injection of aflibercept suppressed the aqueous VEGF concentrations to below the lower limit of quantification (<4 pg/mL) in all patients. The mean duration of VEGF suppression below the lower limit of quantification was >71 ± 18 days. The earliest time after injection at which the VEGF concentration recovered to above the lower limit of quantification was 55 days in 1 patient and >56 days, the recommended aflibercept treatment interval, in 20 patients. The aqueous VEGF recovery status of 6 patients was uncertain after 56 days.
On average, VEGF concentrations in the aqueous humor were suppressed below the lower limit of quantification after intravitreal aflibercept injections for about 10 weeks. This aqueous suppression time suggests durable VEGF inhibition for most patients dosed with aflibercept every 8 weeks.
确定接受阿柏西普治疗的新生血管性年龄相关性黄斑变性（AMD）患者眼中血管内皮生长因子（VEGF）房水浓度的抑制持续时间。
非随机前瞻性临床研究。
本研究纳入了27例接受玻璃体内阿柏西普注射的新生血管性AMD患者的27只眼，注射方案根据频域光学相干断层扫描（SD OCT）结果按需进行。在玻璃体内注射阿柏西普之前共收集了132份房水标本，并通过多重微珠分析测定其VEGF-A浓度。
治疗开始前房水VEGF的平均浓度为90.6±37.1 pg/mL（范围23.4 - 190.3 pg/mL）。玻璃体内注射阿柏西普使所有患者的房水VEGF浓度降至定量下限以下（<4 pg/mL）。VEGF浓度抑制至定量下限以下的平均持续时间>71±18天。注射后VEGF浓度恢复至定量下限以上的最早时间，1例患者为55天，20例患者>56天（推荐的阿柏西普治疗间隔）。6例患者在56天后房水VEGF的恢复情况不确定。
平均而言，玻璃体内注射阿柏西普后房水VEGF浓度被抑制至定量下限以下约10周。这种房水抑制时间表明，对于大多数每8周接受一次阿柏西普治疗的患者，VEGF抑制作用持久。
