Vandekerckhove Kristof R O A
Vista Alpina eye center, Bahnhofplatz 1A, 3930, Visp, Switzerland,
Int Ophthalmol. 2015 Aug;35(4):603-9. doi: 10.1007/s10792-015-0081-7. Epub 2015 May 20.
The purpose of this study was to compare the efficacy of intravitreal aflibercept versus ranibizumab for treating therapy-resistant diabetic macular oedema (DME). A 69-year-old man presented with persistent bilateral DME despite previous ranibizumab treatment. Bilateral study treatment comprised one cycle of three monthly ranibizumab injections (0.5 mg), followed by one cycle of three aflibercept injections (2.0 mg), a second ranibizumab cycle and a second aflibercept cycle. Baseline visual acuity (ETDRS score) was 60 letters for the right eye and 65 letters for the left eye. Baseline central foveal thickness (CFT) was 305 μm for the right eye and 453 μm for the left eye. Substantially improved outcomes were observed during the first aflibercept cycle. CFT was reduced by 150 μm (mean) in both the eyes and decreased below the lowest level achieved during the previous 2.5-year ranibizumab treatment. Visual acuity was improved by 17.5 letters (mean) in both the eyes. Reintroduction of ranibizumab immediately worsened the status of both eyes back to the baseline level. During the final aflibercept cycle, visual acuity and CFT improved to the same levels achieved during the first aflibercept cycle. In this case study, we prospectively switched the treatment three times and observed a dramatic and consistent treatment advantage for aflibercept.
本研究的目的是比较玻璃体内注射阿柏西普与雷珠单抗治疗难治性糖尿病性黄斑水肿（DME）的疗效。一名69岁男性，尽管之前接受过雷珠单抗治疗，但仍患有持续性双侧DME。双侧研究性治疗包括一个周期，即每月注射三次雷珠单抗（0.5mg），随后是一个周期的三次阿柏西普注射（2.0mg），第二个雷珠单抗周期和第二个阿柏西普周期。右眼的基线视力（ETDRS评分）为60个字母，左眼为65个字母。右眼的基线中心凹厚度（CFT）为305μm，左眼为453μm。在第一个阿柏西普周期中观察到明显改善的结果。双眼的CFT平均降低了150μm，并降至之前2.5年雷珠单抗治疗期间所达到的最低水平以下。双眼的视力平均提高了17.5个字母。重新使用雷珠单抗立即使双眼的状况恶化至基线水平。在最后一个阿柏西普周期中，视力和CFT改善至第一个阿柏西普周期所达到的相同水平。在本病例研究中，我们前瞻性地进行了三次治疗转换，并观察到阿柏西普具有显著且一致的治疗优势。
