The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Marsden Eye Specialists, Parramatta, New South Wales, Australia.
Retina. 2018 Oct;38(10):1954-1961. doi: 10.1097/IAE.0000000000001815.
To assess the effect of intravitreal ranibizumab and aflibercept on retinal pigment epithelial detachment (RPED) in patients with neovascular age-related macular degeneration.
This was a retrospective analysis of data from a prospectively designed and implemented clinical audit. Analysis included change in RPED dimensions and visual acuity in 92/233 treatment-naive eyes with neovascular age-related macular degeneration and RPED 6 months after treatment with either aflibercept or ranibizumab.
There was no significant between-group difference in the adjusted mean change for maximum RPED height (P = 0.195), diameter (P = 0.522) or visual acuity (P = 0.836) at 6 months. Injection frequency was the only clinical variable that affected RPED height (P = 0.050) and visual acuity change for both treatment groups (P = 0.004). Around 30% of eyes in each group had complete resolution of RPED at 6 months.
Eyes with neovascular age-related macular degeneration and RPED showed significant functional and anatomical responses after 6 months of intravitreal anti-vascular endothelial growth factor injections. However, we found no significant difference in anatomical response or change in visual acuity between eyes treated with ranibizumab compared with aflibercept. Larger, prospectively designed, randomized studies with longer term follow-up may identify a difference between the two drugs that we did not detect.
评估玻璃体内雷珠单抗和阿柏西普对新生血管性年龄相关性黄斑变性患者视网膜色素上皮脱离(RPED)的影响。
这是一项回顾性分析,对一项前瞻性设计和实施的临床审计数据进行了分析。分析包括治疗前未经治疗的 233 只新生血管性年龄相关性黄斑变性伴 RPED 的眼中,6 个月时雷珠单抗或阿柏西普治疗后 RPED 尺寸和视力的变化;还包括治疗前未经治疗的 92 只眼中的 RPED 尺寸和视力的变化。
调整后的最大 RPED 高度(P = 0.195)、直径(P = 0.522)或视力(P = 0.836)在 6 个月时的平均变化,两组间无显著差异。注射频率是唯一影响两组 RPED 高度(P = 0.050)和视力变化(P = 0.004)的临床变量。两组中约 30%的眼在 6 个月时完全缓解 RPED。
新生血管性年龄相关性黄斑变性和 RPED 的眼在玻璃体内抗血管内皮生长因子注射 6 个月后显示出显著的功能和解剖反应。然而,我们发现雷珠单抗治疗的眼与阿柏西普治疗的眼在解剖学反应或视力变化方面没有显著差异。更大的、前瞻性设计的、随机的、长期随访的研究可能会发现我们没有检测到的两种药物之间的差异。