Yogi Rohit, Stewart Michael, Chhablani Jay
*Srimati Kanuri Santhamma Centre for Vitreo-Retinal Diseases, Hyderabad Eye Research Foundation, Kallam Anji Reddy Campus, L. V. Prasad Eye Institute, Hyderabad, India; and †Department of Ophthalmology, Mayo Clinic, Florida.
Retin Cases Brief Rep. 2017;11(2):111-113. doi: 10.1097/ICB.0000000000000305.
To report flattening of a treatment-resistant retinal pigment epithelial detachment (PED) due to neovascular age-related macular degeneration after a single intravitreal injection of ziv-aflibercept (Zaltrap).
A 67-year-old woman with a neovascular age-related macular degeneration-related PED was treated with intravitreal injections of bevacizumab and ranibizumab, and in combination with verteporfin photodynamic therapy, before receiving a single intravitreal injection of ziv-aflibercept (1.25 mg/0.05 mL).
The patient presented with a visual acuity of 20/30 in the right eye, a PED height of 581 μm, and a central macular thickness of 381 μm. She received eight intravitreal injections of bevacizumab and ranibizumab, one in combination with photodynamic therapy. The height of the PED and the central macular thickness varied over time, but 3 years later, they measured 382 μm and 418 μm, respectively. A single intravitreal injection of ziv-aflibercept resulted in a dramatic reduction in PED height to 140 μm, which was maintained 2 months later. The visual acuity remained stable, and there were no clinical signs of toxicity.
Intravitreal ziv-aflibercept safely and effectively improved a treatment-resistant PED. Intravitreal ziv-aflibercept could become a treatment option for neovascular age-related macular degeneration in countries where aflibercept (Eylea) is not available or its cost is prohibitive, but further studies are necessary to establish efficacy and safety.
报告在玻璃体内单次注射阿柏西普（Zaltrap）后，因新生血管性年龄相关性黄斑变性导致的治疗抵抗性视网膜色素上皮脱离（PED）变平的情况。
一名患有新生血管性年龄相关性黄斑变性相关PED的67岁女性，在接受玻璃体内单次注射阿柏西普（1.25毫克/0.05毫升）之前，接受了玻璃体内注射贝伐单抗和雷珠单抗治疗，并联合维替泊芬光动力疗法。
患者右眼视力为20/30，PED高度为581微米，中心黄斑厚度为381微米。她接受了8次玻璃体内注射贝伐单抗和雷珠单抗，其中1次联合光动力疗法。PED高度和中心黄斑厚度随时间变化，3年后分别为382微米和418微米。玻璃体内单次注射阿柏西普使PED高度显著降低至140微米，并在2个月后保持稳定。视力保持稳定，且无毒性临床体征。
玻璃体内注射阿柏西普安全有效地改善了治疗抵抗性PED。在阿柏西普（阿瓦斯汀）无法获得或成本过高的国家，玻璃体内注射阿柏西普可能成为新生血管性年龄相关性黄斑变性的一种治疗选择，但需要进一步研究以确定其疗效和安全性。
