Wood Edward H, Karth Peter A, Moshfeghi Darius M, Leng Theodore
Ophthalmic Surg Lasers Imaging Retina. 2015 Oct;46(9):950-4. doi: 10.3928/23258160-20151008-08.
Aflibercept is a vascular endothelial growth factor (VEGF) inhibitor recently approved by the U.S. Food and Drug Administration for the treatment of diabetic macular edema (DME). Currently, the effect of switching to aflibercept from other anti-VEGF agents for DME is unknown.
In this prospective, interventional case series, DME patients with persistent retinal fluid despite regular (every 4 to 6 weeks) intravitreal injection (IVI) with ranibizumab 0.3 mg, and/or bevacizumab 1.25 mg were switched to IVI aflibercept 2 mg. Collected data included visual acuity, central subfield foveal thickness (CSFT), and the area of thickest edema on registered spectral-domain optical coherence tomography (SD-OCT).
At 1 month after the first aflibercept IVI, 79% (11 of 14 eyes) showed anatomic improvement with a 23% decrease in average CSFT from 421 µm to 325 µm (P < .0132).
A majority of patients with DME with persistent fluid on SD-OCT despite regular ranibizumab 0.3 mg and/or bevacizumab 1.25 mg IVIs showed a positive anatomic response to IVI aflibercept 2 mg.
阿柏西普是一种血管内皮生长因子（VEGF）抑制剂，最近被美国食品药品监督管理局批准用于治疗糖尿病性黄斑水肿（DME）。目前，从其他抗VEGF药物转换为阿柏西普治疗DME的效果尚不清楚。
在这个前瞻性干预性病例系列中，尽管每4至6周定期玻璃体内注射（IVI）0.3mg雷珠单抗和/或1.25mg贝伐单抗，但仍存在持续性视网膜积液的DME患者被转换为IVI注射2mg阿柏西普。收集的数据包括视力、中心凹下中央厚度（CSFT）以及经注册的光谱域光学相干断层扫描（SD-OCT）上最厚水肿区域。
首次IVI注射阿柏西普后1个月，79%（14只眼中的11只）显示出解剖学改善，平均CSFT从421µm下降23%至325µm（P <.0132）。
尽管定期IVI注射0.3mg雷珠单抗和/或1.25mg贝伐单抗，但在SD-OCT上仍有持续性积液的大多数DME患者对IVI注射2mg阿柏西普显示出积极的解剖学反应。
