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真实世界中眼内抗血管内皮生长因子药物治疗视网膜毛细血管瘤增生

Intravitreal Anti-Vascular Endothelial Growth Factor Drugs for Retinal Angiomatous Proliferation in Real-Life Practice.

机构信息

1 Department of Ophthalmology, San Raffaele Hospital, Università Vita e Salute , Milano, Italy .

2 Section of Ophthalmology, Department of Surgical and Morphological Sciences, University of Insubria , Varese-Como, Italy .

出版信息

J Ocul Pharmacol Ther. 2017 Mar;33(2):123-127. doi: 10.1089/jop.2016.0091. Epub 2017 Jan 3.

Abstract

PURPOSE

To describe the outcomes of intravitreal anti-vascular endothelial growth factor (VEGF) in the treatment of retinal angiomatous proliferation (RAP) in real-life practice in 7 Italian centers under the Progetto Luce initiative.

METHODS

Clinical data of 95 eyes of 95 patients affected by RAP, regularly followed up and treated with either intravitreal ranibizumab or bevacizumab over 12 months, were examined. After a loading phase of 3 consecutive injections, retreatments were administered following a pro-re-nata regimen on the basis of the persistence or the recurrence of subretinal/intraretinal fluid on optical coherence tomography, or leakage on fluorescein angiography.

RESULTS

Overall, the mean best corrected visual acuity changed from 0.66 to 0.53 LogMAR (P: 0.0003); 36.8% of eyes gained at least 3 ETDRS lines, whereas 13.7% lost >3 lines at the end of the follow-up. Mean central retinal thickness improved from 384 μm at baseline to 262 μm at the 12-month examination (P < 0.001). A serous pigment epithelium detachment (PED) was identified in 68.4% of eyes at baseline, and it was still detectable in 30.5% at the end of follow-up. The mean number of injections was 4.4 over the follow-up. A significantly greater proportion of eyes showed PED resolution in the subgroup treated with ranibizumab (P < 0.001).

CONCLUSIONS

Intravitreal anti-VEGF treatment in routine clinical practice allows a significant improvement in visual function in patients affected by RAP. A limited number of anti-VEGF injections are generally required in most cases.

摘要

目的

描述意大利 7 家中心在 Progetto Luce 计划下,采用抗血管内皮生长因子(VEGF)眼内注射治疗视网膜毛细血管瘤增生(RAP)的真实世界疗效。

方法

对 95 例 95 只眼 RAP 患者的临床资料进行回顾性分析,这些患者定期接受抗 VEGF 药物(雷珠单抗或贝伐珠单抗)治疗,随访 12 个月。治疗方案为 3 次连续注射负荷剂量后,根据 OCT 显示的视网膜下/视网膜内液是否持续或复发,或 FA 显示的渗漏,进行个体化的治疗。

结果

平均最佳矫正视力从 0.66 降至 0.53 LogMAR(P:0.0003);36.8%的眼视力提高了至少 3 个 ETDRS 字母,而 13.7%的眼在随访结束时视力下降超过 3 个字母。平均中心视网膜厚度从基线的 384μm 改善至 12 个月时的 262μm(P<0.001)。基线时 68.4%的眼存在浆液性色素上皮脱离(PED),随访结束时仍有 30.5%的眼存在 PED。平均注射次数为 4.4 次。与贝伐珠单抗相比,雷珠单抗治疗组的 PED 缓解比例更高(P<0.001)。

结论

在常规临床实践中,眼内抗 VEGF 治疗可显著改善 RAP 患者的视力功能。大多数情况下,通常需要注射有限数量的抗 VEGF 药物。

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