Aghdam Kaveh Abri, Pielen Amelie, Framme Carsten, Junker Bernd
Department of Ophthalmology, University Eye Hospital, Hannover Medical School, Hannover - Germany.
Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran - Iran.
Eur J Ophthalmol. 2016 Aug 4;26(5):473-8. doi: 10.5301/ejo.5000757. Epub 2016 Feb 5.
To investigate 12-month outcomes of conversion to aflibercept in patients with neovascular age-related macular degeneration resistant to ranibizumab.
Twenty-two eyes of 19 consecutive patients received 3 monthly aflibercept injections followed by a pro re nata protocol. Spectral-domain optical coherence tomography (OCT) images were obtained before each injection. All 49 cross-sectional OCT B-scans obtained in each examination were investigated and the largest choroidal neovascularization (CNV) size was chosen. The same cross-sectional B-scan sections containing the maximum CNV size were used during the follow-up.
After 12 months, best-corrected visual acuity increased from 45.68 ± 20.25 to 59.09 ± 17.50 Early Treatment Diabetic Retinopathy Study letters (p<0.001), central subfield thickness decreased from 399.91 ± 148.85 to 304.55 ± 97.89 μm (p = 0.003), area of CNV declined from 0.38 ± 0.24 to 0.28 ± 0.19 mm2 (p = 0.003), and macular volume improved from 9.64 ± 1.75 to 8.45 ± 0.98 mm3 (p<0.001). There was a significant resolution of intraretinal fluid (p = 0.016), but reduction of subretinal fluid was not significant (p = 0.25).
Visual and anatomic improvement were obtained after conversion to aflibercept.
研究对雷珠单抗耐药的新生血管性年龄相关性黄斑变性患者转换为阿柏西普治疗12个月的疗效。
19例连续患者的22只眼接受每月1次，共3次的阿柏西普注射，之后按需给药。每次注射前均获取频域光学相干断层扫描（OCT）图像。对每次检查获得的49幅横断面OCT B扫描图像进行研究，选取最大脉络膜新生血管（CNV）面积。随访期间使用包含最大CNV面积的相同横断面B扫描图像。
12个月后，最佳矫正视力从45.68±20.25提高至59.09±17.50早期糖尿病性视网膜病变研究视力表字母（p<0.001），中心子野厚度从399.91±148.85降至304.55±97.89μm（p = 0.003），CNV面积从0.38±0.24降至0.28±0.19mm²（p = 0.003），黄斑体积从9.64±1.75改善至8.45±0.98mm³（p<0.001）。视网膜内液明显消退（p = 0.016），但视网膜下液减少不明显（p = 0.25）。
转换为阿柏西普治疗后视力和解剖结构均有改善。
