玻璃体内注射阿柏西普治疗抵抗性新生血管性年龄相关性黄斑变性的临床疗效和解剖结构。
Visual and anatomical outcomes of intravitreal aflibercept for treatment-resistant neovascular age-related macular degeneration.
机构信息
Sapienza University of Rome, Policlinico Umberto I Hospital, 155 Viale del Policlinico, 00161 Rome, Italy.
Casa di Cura Privata Villa Benedetta, 65 Circonvallazione Cornelia, 00165 Rome, Italy.
出版信息
Biomed Res Int. 2014;2014:273754. doi: 10.1155/2014/273754. Epub 2014 May 7.
A retrospective chart review of patients with persistent subretinal and/or intraretinal fluid, despite previous treatment with intravitreal ranibizumab (0.5 mg), who were switched to aflibercept injections, was performed. Treatment was three monthly aflibercept (2 mg) injections followed by dosing on pro re nata basis. Main outcome measures included changes in best corrected visual acuity (BCVA), 1 mm central subfield (CSF) retinal thickness, the height of the pigment epithelial detachment (PED), and subfoveal choroidal thickness on optical coherence tomography at 6 months. Thirty-one eyes of 30 patients were analyzed. The mean number of injections before aflibercept conversion was 34.4 ± 11.9. After an average of 4.5 aflibercept injections (range 3 to 6) over 6 months, no significant change in BCVA was observed (P > 0.05). Compared with baseline, there was a significant reduction of the CSF retinal thickness (449 ± 179 versus 269 ± 145 μ m, P < 0.001), maximum PED height (262 ± 134 versus 183 ± 100 μ m, P < 0.001), and choroidal thickness (192 ± 67 versus 167 ± 51 μ m, P < 0.01). Stable visual acuity and anatomical improvement were obtained for up to 6 months after aflibercept conversion. However, choroidal thinning related to treatment was observed.
对先前接受玻璃体内雷珠单抗(0.5mg)治疗但仍存在持续性视网膜下和/或视网膜内液的患者进行了回顾性图表分析,这些患者随后改用阿柏西普注射剂治疗。治疗方案为每 3 个月注射阿柏西普(2mg),随后按需给药。主要观察指标包括治疗 6 个月时最佳矫正视力(BCVA)、1mm 中心视网膜厚度(CSF)、色素上皮脱离(PED)高度和光学相干断层扫描(OCT)下的中心凹下脉络膜厚度的变化。对 30 名患者的 31 只眼进行了分析。阿柏西普转换前的平均注射次数为 34.4±11.9 次。在平均 4.5 次阿柏西普注射(3 至 6 次)后,6 个月时 BCVA 无显著变化(P>0.05)。与基线相比,CSF 视网膜厚度显著降低(449±179μm 与 269±145μm,P<0.001),最大 PED 高度显著降低(262±134μm 与 183±100μm,P<0.001),脉络膜厚度也显著降低(192±67μm 与 167±51μm,P<0.01)。阿柏西普转换后最多可获得长达 6 个月的稳定视力和解剖改善。然而,观察到与治疗相关的脉络膜变薄。