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玻璃体内注射阿柏西普治疗视网膜血管瘤样增生的短期疗效

Short-term efficacy of intravitreal Aflibercept injections for retinal angiomatous proliferation.

作者信息

Chou Hung-Da, Wu Wei-Chi, Wang Nan-Kai, Chuang Lan-Hsin, Chen Kuan-Jen, Lai Chi-Chun

机构信息

Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, Republic of China.

School of Medicine, Chang Gung University, No. 259, Wenhua 1st Rd., Guishan Dist., Taoyuan City, 333, Taiwan, Republic of China.

出版信息

BMC Ophthalmol. 2017 Jun 27;17(1):104. doi: 10.1186/s12886-017-0497-0.

Abstract

BACKGROUND

To evaluate the short-term efficacy of intravitreal injections of aflibercept (IVA) to treat retinal angiomatous proliferation (RAP) and identify factors related to functional outcomes.

METHODS

This retrospective case series consisted of 19 eyes in 19 patients with RAP. All 19 eyes received 3 monthly consecutive IVA. The primary outcome measures were best-corrected visual acuity (BCVA) and central retinal thickness (CRT) after the last IVA.

RESULTS

Of the 19 treated eyes, 8 (42%) were pre-treated with 1 dose of bevacizumab one month prior to the initiation of treatment with aflibercept. BCVA was significantly improved and CRT was significantly reduced after 3 consecutive IVAs (P = 0.014 and P = 0.0002, respectively). Stabilization or improvement in BCVA was observed in 17 eyes (90%) treated with IVA. Eyes with baseline fibrovascular pigment epithelial detachment (PED) showed no significant gain in BCVA, and fibrovascular PED was negatively correlated with final BCVA (Spearman's correlation coefficient = - 0.481, P = 0.037). The mean follow-up was 3.5 ± 0.5 months.

CONCLUSIONS

In this short-term study, three consecutive IVAs showed efficacy for improving vision and reducing retinal edema in RAP patients. Eyes with fibrovascular PED showed poorer responses, and the presence of fibrovascular PED at baseline was negatively correlated with visual outcomes.

摘要

背景

评估玻璃体内注射阿柏西普(IVA)治疗视网膜血管瘤样增生(RAP)的短期疗效,并确定与功能预后相关的因素。

方法

本回顾性病例系列研究纳入了19例RAP患者的19只眼。所有19只眼均连续3个月每月接受一次IVA注射。主要观察指标为最后一次IVA注射后的最佳矫正视力(BCVA)和中心视网膜厚度(CRT)。

结果

在19只接受治疗的眼中,8只眼(42%)在开始阿柏西普治疗前1个月预先接受了1剂贝伐单抗治疗。连续3次IVA注射后,BCVA显著改善,CRT显著降低(分别为P = 0.014和P = 0.0002)。接受IVA治疗的17只眼(90%)的BCVA得到稳定或改善。基线时存在纤维血管性色素上皮脱离(PED)的眼,其BCVA无显著提高,且纤维血管性PED与最终BCVA呈负相关(Spearman相关系数 = - 0.481,P = 0.037)。平均随访时间为3.5 ± 0.5个月。

结论

在这项短期研究中,连续3次IVA注射显示出对改善RAP患者视力和减轻视网膜水肿的疗效。存在纤维血管性PED的眼反应较差,且基线时纤维血管性PED的存在与视觉预后呈负相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9634/5488380/6de10a21d636/12886_2017_497_Fig1_HTML.jpg

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