Koizumi Hideki, Kano Mariko, Yamamoto Akiko, Saito Masaaki, Maruko Ichiro, Sekiryu Tetsuju, Okada Annabelle A, Iida Tomohiro
Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan.
Fukushima Medical University, Fukushima, Japan.
Br J Ophthalmol. 2015 Sep;99(9):1284-8. doi: 10.1136/bjophthalmol-2014-306432. Epub 2015 Mar 16.
BACKGROUND/AIMS: To investigate short-term outcomes of intravitreal aflibercept injections (IAIs) for polypoidal choroidal vasculopathy (PCV).
91 eyes of 88 consecutive patients with treatment-naive PCV examined at three university hospitals received IAI monthly for 3 months. One month after the third IAI, changes in best-corrected visual acuity (BCVA) and macular morphology were retrospectively evaluated. Additionally, possible baseline characteristics predictive of persistent retinal fluid were analysed.
The mean BCVA (logarithm of the minimum angle of resolution units) of the 91 eyes improved from 0.31 at baseline to 0.21 at 3 months (p<0.0001). The mean central retinal thickness and mean subfoveal choroidal thickness decreased from 323 μm and 270 μm at baseline to 185 μm and 232 μm at 3 months, respectively (p<0.0001 for both). Seventy-three eyes (80.2%) achieved a dry macula defined as absence of retinal fluid. Presence of the baseline characteristics of subretinal haemorrhage and greater size of the largest polyp were significantly associated with inability to achieve a dry macula (p=0.008 and 0.03, respectively). However, this association was not found on multivariate logistic regression. Of the 90 eyes that underwent indocyanine green angiography at 3 months, 43 eyes (47.8%) showed complete and 28 eyes (31.1%) showed partial resolution of polyps. Twenty-four eyes (24.4%) also showed partial regression of branching choroidal vascular networks.
IAIs for the treatment of a large number of PCV eyes were found to improve both visual acuity and macular morphology over the short term.
背景/目的:研究玻璃体内注射阿柏西普(IAIs)治疗息肉状脉络膜血管病变(PCV)的短期疗效。
在三家大学医院检查的88例初治PCV患者的91只眼,每月接受IAI治疗,共3个月。在第三次IAI治疗后1个月,回顾性评估最佳矫正视力(BCVA)和黄斑形态的变化。此外,分析可能预测持续性视网膜积液的基线特征。
91只眼的平均BCVA(最小分辨角对数单位)从基线时的0.31提高到3个月时的0.21(p<0.0001)。平均中心视网膜厚度和平均黄斑下脉络膜厚度分别从基线时的323μm和270μm降至3个月时的185μm和232μm(两者均p<0.0001)。73只眼(80.2%)达到了定义为无视网膜积液的干性黄斑。视网膜下出血的基线特征和最大息肉的较大尺寸与无法达到干性黄斑显著相关(分别为p=0.008和0.03)。然而,在多因素逻辑回归中未发现这种关联。在3个月时接受吲哚菁绿血管造影的90只眼中,43只眼(47.8%)息肉完全消退,28只眼(31.1%)息肉部分消退。24只眼(24.4%)还显示分支脉络膜血管网部分消退。
发现IAIs治疗大量PCV眼可在短期内改善视力和黄斑形态。