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玻璃体内注射阿柏西普和雷珠单抗治疗息肉状脉络膜血管病变

Intravitreal Aflibercept and Ranibizumab Injections for Polypoidal Choroidal Vasculopathy.

作者信息

Cho Han Joo, Kim Kyoung Min, Kim Hyoung Seok, Han Jung Il, Kim Chul Gu, Lee Tae Gon, Kim Jong Woo

机构信息

Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea.

Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea.

出版信息

Am J Ophthalmol. 2016 May;165:1-6. doi: 10.1016/j.ajo.2016.02.019. Epub 2016 Feb 24.

Abstract

PURPOSE

To compare the effectiveness of intravitreal injection of aflibercept and ranibizumab for patients with polypoidal choroidal vasculopathy (PCV).

DESIGN

Retrospective, interventional case series.

METHODS

Ninety-eight treatment-naïve PCV eyes were included. The eyes had received intravitreal aflibercept or ranibizumab injections. All patients were treated using an initial series of 3 monthly loading injections, followed by further injections as required. The visual and anatomic outcomes of treatment were evaluated after 12 months.

RESULTS

The mean best-corrected visual acuity (BCVA) in the aflibercept-treated group (38 eyes), expressed as the logarithm of the minimal angle of resolution (logMAR), had decreased from 0.63 ± 0.49 to 0.44 ± 0.37 after 12 months of treatment (P = .012). Similarly, in the ranibizumab-treated group (60 eyes), the BCVA had decreased from 0.66 ± 0.43 to 0.49 ± 0.36 (P = .018). The central foveal thickness had decreased in the aflibercept-treated group from 396 ± 167 μm to 212 ± 144 μm, and in the ranibizumab-treated group from 402 ± 198 μm to 240 ± 183 μm (P < .001 in both cases). However, there was no significant difference between the groups with regard to either BCVA improvement or decrease in central foveal thickness. Polyp regression was significantly more frequent in the aflibercept-treated group, occurring in 39.5% of eyes, than in the ranibizumab-treated group (21.6% of eyes; P = .007).

CONCLUSIONS

In PCV patients, the visual acuity improvement achieved after 12 months of intravitreal aflibercept did not differ significantly from that achieved using intravitreal ranibizumab. However, aflibercept treatment more often led to polyp regression than did treatment using ranibizumab.

摘要

目的

比较玻璃体内注射阿柏西普和雷珠单抗治疗息肉状脉络膜血管病变(PCV)患者的疗效。

设计

回顾性干预病例系列研究。

方法

纳入98只初治PCV患眼。这些患眼接受了玻璃体内阿柏西普或雷珠单抗注射。所有患者均接受最初连续3个月每月1次的负荷注射,随后根据需要进一步注射。12个月后评估治疗的视力和解剖学结果。

结果

阿柏西普治疗组(38只眼)的平均最佳矫正视力(BCVA),以最小分辨角对数(logMAR)表示,治疗12个月后从0.63±0.49降至0.44±0.37(P = 0.012)。同样,雷珠单抗治疗组(60只眼)的BCVA从0.66±0.43降至0.49±0.36(P = 0.018)。阿柏西普治疗组的中心凹厚度从396±167μm降至212±144μm,雷珠单抗治疗组从402±198μm降至240±183μm(两种情况P均<0.001)。然而,两组在BCVA改善或中心凹厚度降低方面无显著差异。阿柏西普治疗组息肉消退明显更频繁,39.5%的患眼出现息肉消退,高于雷珠单抗治疗组(21.6%的患眼;P = 0.007)。

结论

在PCV患者中,玻璃体内注射阿柏西普12个月后实现的视力改善与玻璃体内注射雷珠单抗实现的视力改善无显著差异。然而,与雷珠单抗治疗相比,阿柏西普治疗更常导致息肉消退。

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