Abri Aghdam Kaveh, Seidensticker Florian, 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.
Lasers Surg Med. 2016 Sep;48(7):668-77. doi: 10.1002/lsm.22531. Epub 2016 Apr 25.
To evaluate the changes in the size of choroidal neovascularization (CNV) lesion using spectral domain-optical coherence tomography (SD-OCT) in patients with treatment-resistant neovascular age-related macular degeneration (AMD) who were switched from ranibizumab to aflibercept.
In this prospective case-series, 33 eyes of 30 patients with treatment-resistant neovascular AMD were included. Treatment-resistant neovascular AMD was defined as choriodal neovascularization secondary to AMD determined by subretinal fluid and/or intraretinal fluid/cysts after more than 6 months of monthly ranibizumab therapy. Enrolled eyes were received intravitreal aflibercept injections at weeks 0, 4, and 8. Maximum area of CNV lesion in the cross-sectional area in the B-scan was measured using Heidelberg Eye Explorer software. The same cross-sectional sections containing maximum area of CNV lesion were used during the follow-up. CNV subtypes were determined based on fluorescein angiography images prior to ranibizumab therapy. Main outcome measures were changes in best-corrected visual acuity (BCVA), central subfield thickness (CST), and area of CNV lesion.
There were five classic (15%), seven minimally classic (21%), and 21 occult subtypes of CNV (64%). Four weeks after the third injection, BCVA improvement and reduction of the retinal thickness in nine standard ETDRS subfields were significant (both P < 0.001). Regarding and regardless of CNV subtypes, mean area of CNV lesion decreased significantly at final visit. Overall, a dry macula was achieved in 21 eyes (64%) and 12 eyes (36%) showed decreased or unchanged edema.
Switching to aflibercept seems to result in reduction of CNV lesion area in short-term follow-up of patients with treatment-resistant neovascular AMD. Lasers Surg. Med. 48:668-677, 2016. © 2016 Wiley Periodicals, Inc.
使用光谱域光学相干断层扫描（SD - OCT）评估治疗抵抗性新生血管性年龄相关性黄斑变性（AMD）患者从雷珠单抗转换为阿柏西普后脉络膜新生血管（CNV）病变大小的变化。
在这个前瞻性病例系列中，纳入了30例治疗抵抗性新生血管性AMD患者的33只眼。治疗抵抗性新生血管性AMD定义为在每月注射雷珠单抗治疗超过6个月后，由视网膜下液和/或视网膜内液/囊肿确定的继发于AMD的脉络膜新生血管。入选的眼睛在第0、4和8周接受玻璃体内阿柏西普注射。使用海德堡眼用图像分析软件测量B扫描中CNV病变横截面的最大面积。在随访期间使用包含CNV病变最大面积的相同横截面。根据雷珠单抗治疗前的荧光素血管造影图像确定CNV亚型。主要观察指标为最佳矫正视力（BCVA）、中心子野厚度（CST）和CNV病变面积的变化。
CNV有5例典型（15%）、7例微小典型（21%）和21例隐匿型（64%）亚型。第三次注射后4周，BCVA改善以及9个标准ETDRS子野视网膜厚度降低均有显著意义（均P < 0.001）。无论CNV亚型如何，末次随访时CNV病变的平均面积均显著减小。总体而言，21只眼（64%）实现了黄斑干性变，12只眼（36%）水肿减轻或未改变。
在治疗抵抗性新生血管性AMD患者的短期随访中，转换为阿柏西普似乎可导致CNV病变面积减小。激光外科与医学。48:668 - 677，2016。©2016威利期刊公司。
