Sakai Tsutomu, Kato Noriko, Kubota Masaomi, Tsuneoka Hiroshi
Department of Ophthalmology, Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Jikei Daisan Hospital, Komae, Japan.
Graefes Arch Clin Exp Ophthalmol. 2017 Aug;255(8):1565-1571. doi: 10.1007/s00417-017-3700-3. Epub 2017 Jun 11.
To evaluate the outcome of triple therapy of photodynamic therapy combined with injections of intravitreal aflibercept (IVA) and subtenon triamcinolone acetonide for polypoidal choroidal vasculopathy (PCV) resistant to IVA.
A retrospective chart review at a single institution was conducted to identify patients with PCV resistant to treatment with IVA who were switched to treatment with triple therapy. In total, 13 eyes from 13 patients were included in the study. Demographic data, visual acuities, central retinal thickness (CRT) and height of pigment epithelial detachment (PED) on optical coherence tomography (OCT), complications, and number of injections were reviewed.
The patients had a mean age of 68 years (range 53-83). The number of prior injections with IVA ranged from 5 to 10. At 12 months follow-up after triple therapy, there was a significant improvement in visual acuity (P = 0.0039), a significant decrease in CRT (P = 0.003), and a significant reduction of the height of PED (P = 0.015). Only one patient had retinal pigment epithelium tear.
Triple therapy improved visual and anatomical outcomes in patients with PCV with recurrent or resistant retinal fluid and PED after multiple injections with IVA.
评估光动力疗法联合玻璃体内注射阿柏西普（IVA）及球周注射曲安奈德治疗对IVA耐药的息肉状脉络膜血管病变（PCV）的疗效。
在单一机构进行回顾性病历审查，以确定对IVA治疗耐药且转而接受三联疗法的PCV患者。本研究共纳入13例患者的13只眼。回顾了人口统计学数据、视力、光学相干断层扫描（OCT）上的中心视网膜厚度（CRT）和色素上皮脱离（PED）高度、并发症及注射次数。
患者的平均年龄为68岁（范围53 - 83岁）。既往IVA注射次数为5至10次。三联疗法后12个月随访时，视力有显著改善（P = 0.0039），CRT显著降低（P = 0.003），PED高度显著减小（P = 0.015）。仅1例患者发生视网膜色素上皮撕裂。
对于多次注射IVA后仍复发或耐药的视网膜积液和PED的PCV患者，三联疗法改善了视力和解剖学结局。
