Almuhtaseb H, Johnston R L, Talks J S, Lotery A J
Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Clinical and Experimental Sciences, University of Southampton, Southampton, UK.
Eye (Lond). 2017 Nov;31(11):1582-1588. doi: 10.1038/eye.2017.108. Epub 2017 Jun 16.
PurposeTo audit the visual acuity (VA) outcomes achieved at the end of year two in 17 UK centres, which followed the year 1 VIEW protocol in year 1, but a variable approach in year 2 for aflibercept for neovascular macular degeneration (nAMD).Patients and methodsRetrospective data analysis, from an electronic medical record, of a consecutive series of treatment-naive nAMD patients who received aflibercept for 2 consecutive years, having followed the VIEW protocol in year one, defined as eyes having received 7 or 8 injections from baseline.ResultsThe mean number of intravitreal injections (IVI)s during year 2 was 3.7 in 1180 eyes (1083 patients). The mean baseline VA of the whole cohort was 56.3 ETDRS letters, improving to 61.3 at 1 year (+5) and 59.1 (+2.8) at the end of year 2. The mean VA letter score at the end of year 2, stratified by number of IVIs into three groups was as follows: group A, 57.3 (gain of +1.7) (44% of eyes (</=3 IVIs)); group B, 59.8 (+3.8) (34% of eyes (4-5 IVIs)); group C, 61.7 (+3.7) (22% of eyes (>/=6 IVIs)). Even though there were VA gains in the three groups over the 2-years, there was a drop in VA in year one to two. Eyes that received >/=6 IVIs (group C) had a smaller reduction of VA during year 2 than those which received </=3 IVIs (group A) (P=0.0014).ConclusionsProviding a higher number of injections after a Q8 regime in year 1 results in higher VA gains in year 2 of treatment.
目的
审核英国17个中心在第二年年底时的视力(VA)结果,这些中心在第一年遵循了第一年的VIEW方案,但在第二年对阿柏西普治疗新生血管性黄斑变性(nAMD)采用了不同的方法。
患者和方法
对一系列连续的初治nAMD患者进行回顾性数据分析,这些患者来自电子病历,连续两年接受阿柏西普治疗,第一年遵循VIEW方案,定义为从基线开始接受7次或8次注射的眼睛。
结果
在1180只眼睛(1083例患者)中,第二年玻璃体内注射(IVI)的平均次数为3.7次。整个队列的平均基线视力为56.3个ETDRS字母,在1年时提高到61.3个(提高了5个),在第二年年底时为59.1个(提高了2.8个)。在第二年年底,根据IVI次数分为三组的平均视力字母评分如下:A组,57.3个(提高了1.7个)(44%的眼睛(≤3次IVI));B组,59.8个(提高了3.8个)(34%的眼睛(4 - 5次IVI));C组,61.7个(提高了3.7个)(22%的眼睛(≥6次IVI))。尽管在这两年中三组的视力都有提高,但在第一年到第二年期间视力有所下降。接受≥6次IVI的眼睛(C组)在第二年的视力下降幅度小于接受≤3次IVI的眼睛(A组)(P = 0.0014)。
结论
在第一年采用每8周一次的方案后进行更多次数的注射,会在治疗的第二年带来更高的视力提高。