Nghiem-Buffet Sylvia, Glacet-Bernard Agnès, Addou-Regnard Manar, Souied Eric H, Cohen Salomon Y, Giocanti-Auregan Audrey
Centre Ophtalmologique d'Imagerie et de Laser, 11 Rue Antoine Bourdelle, Paris, France.
Ophthalmology Department, DHU Vision and Handicaps, APHP, Avicenne Hospital, Paris 13 University, 125 Rue de Stalingrad, Bobigny, France.
J Ophthalmol. 2018 Jul 15;2018:8656495. doi: 10.1155/2018/8656495. eCollection 2018.
To assess treatment interval extension after switching from ranibizumab to aflibercept intravitreal injections in macular edema (ME) due to central retinal vein occlusion (CRVO) with an insufficient response or frequent recurrences to initial treatment.
CRVO eyes treated with ranibizumab injections on a treat-and-extend (TAE) basis with an insufficient response or frequent recurrences were switched to aflibercept. Primary endpoint was the change in injection intervals before and after the switch.
Eleven eyes were included in this retrospective bicentric study. Before switching, patients received a mean number of 15.3 ranibizumab injections (range, 6-34) during a mean follow-up of 23.4 months (range, 6-57). After switching to aflibercept, patients received a mean number of 12.4 injections (range, 6-20) during a mean follow-up of 25.5 months (range, 16-38). Treatment interval could be extended from 6.1 (range, 4-8) to 11 weeks (range, 8-16) (=0.001) corresponding to a mean extension of injection interval of +4.9 weeks.
In case of insufficient response or frequent recurrences of ME due to CRVO in patients treated with ranibizumab on a TAE basis, switching to aflibercept could allow extending treatment intervals, which could reduce the injection burden for these patients.
评估在黄斑水肿（ME）因视网膜中央静脉阻塞（CRVO）而对初始治疗反应不足或频繁复发的患者中，从雷珠单抗转换为阿柏西普玻璃体内注射后的治疗间隔延长情况。
对在 treat-and-extend（TAE）基础上接受雷珠单抗注射但反应不足或频繁复发的 CRVO 患眼，转换为阿柏西普治疗。主要终点是转换前后注射间隔的变化。
这项回顾性双中心研究纳入了 11 只眼睛。转换前，患者在平均 23.4 个月（范围 6 - 57 个月）的随访期间平均接受 15.3 次雷珠单抗注射（范围 6 - 34 次）。转换为阿柏西普后，患者在平均 25.5 个月（范围 16 - 38 个月）的随访期间平均接受 12.4 次注射（范围 6 - 20 次）。治疗间隔可从 6.1 周（范围 4 - 8 周）延长至 11 周（范围 8 - 16 周）（P = 0.001），对应注射间隔平均延长 +4.9 周。
对于在 TAE 基础上接受雷珠单抗治疗的 CRVO 患者，若出现 ME 反应不足或频繁复发，转换为阿柏西普可延长治疗间隔，从而减轻这些患者的注射负担。
