Braimah Imoro Zeba, Agarwal Komal, Mansour Ahmad, Chhablani Jay
School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana.
Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, KAR Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Br J Ophthalmol. 2018 Jan;102(1):91-96. doi: 10.1136/bjophthalmol-2017-310318. Epub 2017 Jun 8.
To evaluate 12-month outcome of intravitreal ziv-aflibercept (IVZ) therapy in eyes with neovascular age-related macular degeneration (nAMD) that are non-responsive to bevacizumab and ranibizumab.
This retrospective study included 16 eyes (14 patients) with nAMD who were on prior treatment with bevacizumab and ranibizumab and were treated with as-needed IVZ (1.25 mg/0.05 mL) for 12 months. The primary outcome measure was the mean change in best corrected visual acuity (BCVA) and secondary outcome measures included mean change in central macular thickness (CMT), retinal pigment epithelial detachment (RPED) heights, longest treatment free interval, presence of subretinal fluid (SRF) and intraretinal fluid (IRF) and adverse events.
There was no change in the mean logarithm of minimum angle of resolution (logMAR) BCVA at baseline and following treatment with IVZ therapy (p=0.978). The mean number of IVZ injections during 12 months was 5.9±3.3, and the mean number of antivascular endothelial growth factors (VEGFs) injections prior to switching to IVZ was 8.4±4.7. The mean treatment free interval was longer during IVZ therapy (114.4±67.1 days) compared with 76.3±54.6 days before IVZ therapy (p=0.03). Five (31.25%) eyes had visual gains of at least 0.1 logMAR, 3 (18.75%) eyes had stable BCVA (within 0.1 logMAR) and 8 (50%) eyes had BCVA decline of at least 0.1 logMAR. There was no significant difference in the mean CMT, RPED heights and presence of IRF and SRF at 12 months compared with baseline. No adverse events were noted.
IVZ increased the treatment free interval in non-responders but no significant change in visual and anatomic outcomes.
评估玻璃体内注射阿柏西普（IVZ）治疗对贝伐单抗和雷珠单抗无反应的新生血管性年龄相关性黄斑变性（nAMD）患者12个月的疗效。
这项回顾性研究纳入了16只眼（14例患者），这些患者之前接受过贝伐单抗和雷珠单抗治疗，随后按需接受IVZ（1.25mg/0.05mL）治疗12个月。主要观察指标是最佳矫正视力（BCVA）的平均变化，次要观察指标包括中心黄斑厚度（CMT）的平均变化、视网膜色素上皮脱离（RPED）高度、最长无治疗间隔、视网膜下液（SRF）和视网膜内液（IRF）的存在情况以及不良事件。
在基线时和接受IVZ治疗后，最小分辨角平均对数（logMAR）BCVA没有变化（p = 0.978）。12个月内IVZ的平均注射次数为5.9±3.3次，在改用IVZ之前抗血管内皮生长因子（VEGF）的平均注射次数为8.4±4.7次。与IVZ治疗前的76.3±54.6天相比，IVZ治疗期间的平均无治疗间隔更长（114.4±67.1天）（p = 0.03）。5只眼（31.25%）视力提高至少0.1 logMAR，3只眼（18.75%）BCVA稳定（在0.1 logMAR以内），8只眼（50%）BCVA下降至少0.1 logMAR。与基线相比，12个月时CMT、RPED高度以及IRF和SRF的存在情况没有显著差异。未观察到不良事件。
IVZ增加了无反应者的无治疗间隔，但视力和解剖学结果无显著变化。
