Epstein David, Amrén Urban
Karolinska Institutet, St Erik Eye Hospital, Stockholm, Sweden.
Retina. 2016 Sep;36(9):1773-7. doi: 10.1097/IAE.0000000000000978.
The aim of this study was to investigate the outcome in near vision and the best-corrected visual acuity in patients with wet, age-related macular degeneration treated with aflibercept in a fixed bimonthly regimen in an ordinary clinical setting.
The study was a retrospective, nonrandomized consecutive case series including 85 patients with wet, age-related macular degeneration followed for 18 months. During the first year all the patients received aflibercept injections in a fixed regimen at the following time points: Month 0, 1, 2, 4, 6, 8, 10, and 12. From Month 12 to Month 18, patients were treated with a treat and extend algorithm.
The median near visual acuity improved from 12 points (95% confidence interval [CI] 10.5-13.4) at baseline to 5 points both at Month 12 (95% CI 3.8-6.2) and at Month 18 (95% CI 3.6-6.4) (P < 0.0001). At the 18-month visit, 58% (42/73) of the patients had a near visual acuity of at least 5 points compared with 7% (6/85) (P < 0.0001) at baseline. Best-corrected visual acuity improved from 60.9 letters (Snellen 20/63) (95% CI 58.4-63.4) at baseline to 68.1 letters (20/40) (95% CI 65.3-70.9) (P < 0.001) at Month 12 and 69.6 letters (20/40) (95% CI 66.7-72.5) (P < 0.001) at Month 18.
Significant improvements were found in near vision and best-corrected visual acuity. The improvement in near vision was comparably greater than the change in best-corrected visual acuity. Monitoring near vision can contribute additional information when managing the patient with wet, age-related macular degeneration.
本研究旨在调查在普通临床环境中,接受阿柏西普固定双月给药方案治疗的湿性年龄相关性黄斑变性患者的近视力结果和最佳矫正视力。
本研究为一项回顾性、非随机连续病例系列研究,纳入85例湿性年龄相关性黄斑变性患者,随访18个月。在第一年,所有患者按照固定方案在以下时间点接受阿柏西普注射:第0、1、2、4、6、8、10和12个月。从第12个月到第18个月,患者采用治疗并延长方案进行治疗。
近视力中位数从基线时的12分(95%置信区间[CI] 10.5 - 13.4)提高到第12个月时的5分(95% CI 3.8 - 6.2)和第18个月时的5分(95% CI 3.6 - 6.4)(P < 0.0001)。在18个月的随访中,58%(42/73)的患者近视力至少为5分,而基线时为7%(6/85)(P < 0.0001)。最佳矫正视力从基线时的60.9个字母(Snellen 20/63)(95% CI 58.4 - 63.4)提高到第12个月时的68.1个字母(20/40)(95% CI 65.3 - 70.9)(P < 0.001)和第18个月时的69.6个字母(20/40)(95% CI 66.7 - 72.5)(P < 0.001)。
近视力和最佳矫正视力均有显著改善。近视力的改善相对大于最佳矫正视力的变化。在管理湿性年龄相关性黄斑变性患者时,监测近视力可提供额外信息。