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玻璃体内注射阿柏西普治疗渗出性年龄相关性黄斑变性后的临床及电生理评估

CLINICAL AND ELECTROPHYSIOLOGICAL EVALUATION AFTER INTRAVITREAL ZIV-AFLIBERCEPT FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

作者信息

de Oliveira Dias João Rafael, de Andrade Gabriel Costa, Kniggendorf Vinicius Ferreira, Novais Eduardo Amorim, Maia André, Meyer Carsten, Watanabe Sung Eun Song, Farah Michel Eid, Rodrigues Eduardo Büchele

机构信息

Department of Ophthalmology, Paulista Medical School, Federal University of São Paulo, São Paulo, Brazil.

出版信息

Retina. 2017 Aug;37(8):1499-1507. doi: 10.1097/IAE.0000000000001385.

Abstract

PURPOSE

To evaluate the 6-month safety and efficacy of ziv-aflibercept intravitreal injections for treating exudative age-related macular degeneration.

METHODS

Fifteen patients with unilateral exudative age-related macular degeneration were enrolled. The best-corrected visual acuity was measured and spectral domain optical coherence tomography was performed at baseline and monthly. Full-field electroretinography and multifocal electroretinography were obtained at baseline and 4, 13, and 26 weeks after the first injection. All patients received three monthly intravitreal injections of ziv-aflibercept (1.25 mg) followed by as-needed treatment.

RESULTS

Between baseline and 26 weeks, the mean logMAR best-corrected visual acuity improved (P = 0.00408) from 0.93 ± 0.4 (20/200) to 0.82 ± 0.5 (20/160) logarithm of the minimum angle of resolution, respectively; the central retinal thickness decreased significantly (P = 0.0007) from 490.3 ± 155.1 microns to 327.9 ± 101.5 microns; the mean total macular volume decreased significantly (P < 0.0001) from 9.51 ± 1.36 mm to 8.08 ± 1.34 mm, and the a-wave implicit time increased, with no differences in the other full-field electroretinography parameters. The average multifocal electroretinography macular responses within the first central 15° showed significantly (P < 0.05) increased P1 amplitudes at 26 weeks. No systemic or ocular complications developed.

CONCLUSION

Intravitreal ziv-aflibercept significantly improved the best-corrected visual acuity, multifocal electroretinography amplitudes, central retinal thickness, and total macular volume from baseline to 26 weeks. No retinal toxicity on full-field electroretinography or adverse events occurred during the follow-up period.

摘要

目的

评估玻璃体内注射阿柏西普治疗渗出性年龄相关性黄斑变性6个月的安全性和有效性。

方法

纳入15例单侧渗出性年龄相关性黄斑变性患者。在基线期及每月测量最佳矫正视力,并进行频域光学相干断层扫描。在基线期以及首次注射后4周、13周和26周进行全视野视网膜电图和多焦视网膜电图检查。所有患者每月接受3次玻璃体内注射阿柏西普(1.25毫克),随后按需治疗。

结果

在基线期至26周期间,平均logMAR最佳矫正视力显著改善(P = 0.00408),分别从0.93±0.4(20/200)的最小分辨角对数提高到0.82±0.5(20/160);中心视网膜厚度从490.3±155.1微米显著降低(P = 0.0007)至327.9±101.5微米;平均黄斑总体积从9.51±1.36立方毫米显著降低(P < 0.0001)至8.08±1.34立方毫米,a波潜伏时间增加,其他全视野视网膜电图参数无差异。在最初的中央15°范围内,多焦视网膜电图黄斑反应在26周时P1振幅显著增加(P < 0.05)。未出现全身或眼部并发症。

结论

从基线期到26周,玻璃体内注射阿柏西普显著改善了最佳矫正视力、多焦视网膜电图振幅、中心视网膜厚度和黄斑总体积。随访期间未出现全视野视网膜电图视网膜毒性或不良事件。

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