Topal Tuncay, Kar Taner, Yıldırım Yıldıray, Sağdıç Sercan Koray, Büyükavşar Cihan, Kaya Abdullah, Ayata Ali, Sönmez Murat, Ünal Melih Hamdi
Haydarpaşa Sultan Abdülhamid Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey.
Anıttepe Military Dispensary, Ankara, Turkey.
Turk J Ophthalmol. 2017 Jun;47(3):133-137. doi: 10.4274/tjo.34735. Epub 2017 Jun 1.
To evaluate anatomic and functional results after switching from intravitreal bevacizumab or ranibizumab treatment to aflibercept for wet (neovascular) age-related macular degeneration.
This retrospective study included 22 eyes of 22 patients resistant to treatment with at least 6 injections of bevacizumab or ranibizumab. The first three injections had been applied monthly, the others pro re nata (PRN). Outcome measures were follow-up period, injection number, best corrected visual acuity (BCVA), central retinal thickness (CRT) and pigment epithelial detachment (PED) height. Dosing regimen of aflibercept was determined PRN. The patients were examined monthly. In all visits, BCVA and optical coherence tomography results were assessed together and injections were applied according to these findings. Patients with at least three months of follow-up were included in the study.
Twenty-two eyes of 22 patients treated with bevacizumab or ranibizumab were switched to aflibercept therapy. Seven patients had serous PED and 4 patients had fibrovascular PED. The mean follow-up periods for these groups were 20.59±6.76 months and 8.68±3.79 months, respectively. The mean injection numbers were 10.5±3.61 vs 4.54±1.56. Statistically significant reductions were noted in CRT (533.86±164.06 µm vs 412.04±143.86 µm, p<0.05). BCVA levels were almost equal before and after switching (0.18±0.17 vs 0.18±0.14). Serous and fibrovascular PED heights decreased suboptimally from 460±281.51 µm to 282.42±175.76 µm (p>0.05) for serous PEDs and 251.25±43.85 µm to 225.75±73.09 µm (p>0.05) for fibrovascular PEDs.
Switching to aflibercept resulted in significant improvement in CRT, but not in BCVA or PED heights.
评估湿性（新生血管性）年龄相关性黄斑变性患者从玻璃体内注射贝伐单抗或雷珠单抗治疗转换为阿柏西普治疗后的解剖学和功能结果。
这项回顾性研究纳入了22例患者的22只眼，这些患者对至少6次注射贝伐单抗或雷珠单抗治疗耐药。前三次注射每月进行一次，其余根据需要（PRN）进行。观察指标包括随访期、注射次数、最佳矫正视力（BCVA）、中心视网膜厚度（CRT）和色素上皮脱离（PED）高度。阿柏西普的给药方案根据需要确定。患者每月接受检查。在所有就诊时，同时评估BCVA和光学相干断层扫描结果，并根据这些结果进行注射。纳入至少随访三个月的患者进行研究。
22例接受贝伐单抗或雷珠单抗治疗的患者的22只眼转换为阿柏西普治疗。7例患者有浆液性PED，4例患者有纤维血管性PED。这些组的平均随访期分别为20.59±6.76个月和8.68±3.79个月。平均注射次数分别为10.5±3.61次和4.54±1.56次。CRT有统计学意义的降低（533.86±164.06 µm对412.04±143.86 µm，p<0.05）。转换前后BCVA水平几乎相等（0.18±0.17对0.18±0.14）。浆液性和纤维血管性PED高度降低不理想，浆液性PED从460±281.51 µm降至282.42±175.76 µm（p>0.05），纤维血管性PED从251.25±43.85 µm降至225.75±73.09 µm（p>0.05）。
转换为阿柏西普治疗可使CRT显著改善，但BCVA或PED高度无改善。
