Pece Alfredo, Milani Paolo
Unità Operativa di Oftalmologia, Ospedale di Melegnano, Via Pandina 1, 20077, Melegnano, (MI), Italy.
Fondazione Retina 3000, Milan, Italy.
Graefes Arch Clin Exp Ophthalmol. 2016 Dec;254(12):2327-2332. doi: 10.1007/s00417-016-3396-9. Epub 2016 Jun 11.
To assess the use of aflibercept for the treatment of subfoveal myopic choroidal neovascularization (CNV).
Thirty-two patients (33 eyes) with myopic subfoveal CNV were consecutively enrolled in this prospective open-label case series. All patients were treated with an off-label 2-mg intravitreal injection of aflibercept. After the first injection, administration of aflibercept followed an "on demand" pro re nata (PRN) regimen. The primary outcome was change in best-corrected visual acuity (BCVA) score after 12 months.
Mean follow-up was 12 months, and the median number of aflibercept injections was 2.0 (range 1-4). Overall, mean BCVA improved from 0.59 ± 0.37 logMAR at baseline to 0.38 ± 0.33 logMAR at 12 months, a change of -0.21 ± 0.23 logMAR (p < 0.0001), and from 70.5 ± 18.5 to 81.1 ± 16.4 letters, a change of 10.6 ± 11.4 (p < 0.0001). Improvements were similar among patients irrespective of previous PDT. The Increase in BCVA was greater in younger patients (aged < 50 years) and those with baseline BCVA of ≤ 75 letters.
Intravitreal aflibercept in a PRN regimen is effective for the treatment of myopic CNV, with no apparent short-term safety effects. Treated eyes had BCVA gains after 12 months, with a median of two injections.
评估阿柏西普用于治疗中心凹下近视性脉络膜新生血管(CNV)的疗效。
本前瞻性开放标签病例系列连续纳入了32例(33只眼)患有近视性中心凹下CNV的患者。所有患者均接受了2mg阿柏西普玻璃体腔注射的非标签治疗。首次注射后,阿柏西普的给药遵循“按需”即按需要(PRN)方案。主要结局是12个月后最佳矫正视力(BCVA)评分的变化。
平均随访时间为12个月,阿柏西普注射的中位数为2.0次(范围1 - 4次)。总体而言,平均BCVA从基线时的0.59±0.37 logMAR提高到12个月时的0.38±0.33 logMAR,变化为-0.21±0.23 logMAR(p < 0.0001),字母数从70.5±18.5提高到81.1±16.4,变化为10.6±11.4(p < 0.0001)。无论先前是否接受过光动力疗法(PDT),患者之间的改善情况相似。年轻患者(年龄 < 50岁)和基线BCVA≤75字母的患者BCVA增加幅度更大。
按需方案的玻璃体腔注射阿柏西普对近视性CNV的治疗有效,且无明显短期安全影响。治疗后的眼睛在12个月后BCVA提高,注射中位数为两次。