Fursova A Zh, Chubar N V, Tarasov M S, Vasilyeva M A, Gusarevich O G
Novosibirsk State Regional Hospital, 130 Nemirovicha-Danchenko St., Novosibirsk, Russian Federation, 630008; Novosibirsk State Medical University, 52 Krasny Prospect, Novosibirsk, Russian Federation, 630008.
Novosibirsk State Regional Hospital, 130 Nemirovicha-Danchenko St., Novosibirsk, Russian Federation, 630008.
Vestn Oftalmol. 2018;134(6):59-67. doi: 10.17116/oftalma201813406159.
To evaluate the clinical effectiveness of aflibercept in treatment of patients with neovascular age-related macular degeneration (nAMD).
The first group included 156 treatment-naive nAMD patients (156 eyes). The second group consisted of 29 patients (38 eyes) with nAMD who had previously received at least 3 loading injections of 0.5 mg ranibizumab but exhibited no morphological effect from the therapy. All patients included in the study were treated with 2.0 mg aflibercept. The follow-up period was 13 months.
In the first group, the average number of injections was 5.1±0.39. A change in best corrected visual acuity (BCVA) after three loading injections was observed in all eyes of the group and amounted to 0.43±0.2. The final visual acuity was 0.47±0.22. After the first injection, central retinal thickness (CRT) in all patients of the group decreased to 346.14±54.53 μm; by the end of treatment it was 281.64±34 μm. Dry macula was achieved in 109 patients (69.9%), which corresponded to the highest BCVA of 0.84±0.14. In 26 patients (16.7%), subretinal fluid (SRF) remained and visual acuity was 0.57±0.22; 14 patients (9%) had pigment epithelium detachment (PED) and visual acuity of 0.63±0.08. Presence of residual intraretinal fluid (IRF) in 7 patients (4.5%) reliably defined the lowest functional result of 0.1±0.22. In the second group, 100% of patients after the first injection of aflibercept had decreased retinal thickness (by an average of 36.99 μm), while the increase in visual acuity was noted only after 3 injections in 67.5% of the eyes. By the end of the follow-up, CRT was 231.44±18.4 μm, decreased on average by 83.65 μm, and the final BCVA was 0.31±0.19. The number of injections was 5.7±1.7.
Aflibercept can be used as the first choice drug in the treatment of nAMD for it improves the anatomical parameters of the retina and the visual functions.
评估阿柏西普治疗新生血管性年龄相关性黄斑变性（nAMD）患者的临床疗效。
第一组包括156例初治nAMD患者（156只眼）。第二组由29例nAMD患者（38只眼）组成，这些患者此前至少接受过3次0.5mg雷珠单抗的负荷注射，但治疗后未出现形态学改善。纳入研究的所有患者均接受2.0mg阿柏西普治疗。随访期为13个月。
第一组平均注射次数为5.1±0.39次。该组所有眼在3次负荷注射后最佳矫正视力（BCVA）均有变化，变化值为0.43±0.2。最终视力为0.47±0.22。首次注射后，该组所有患者的中心视网膜厚度（CRT）降至346.14±54.53μm；治疗结束时为281.64±34μm。109例患者（69.9%）实现了黄斑干燥，此时BCVA最高，为0.84±0.14。26例患者（16.7%）仍存在视网膜下液（SRF），视力为0.57±0.22；14例患者（9%）有色素上皮脱离（PED），视力为0.63±0.08。7例患者（4.5%）存在残留视网膜内液（IRF），其功能结果最低，为0.1±0.22。在第二组中，100%的患者在首次注射阿柏西普后视网膜厚度下降（平均下降36.99μm），而仅67.5%的眼在3次注射后视力提高。随访结束时，CRT为231.44±18.4μm，平均下降83.65μm，最终BCVA为0.31±0.19。注射次数为5.7±1.7次。
阿柏西普可作为治疗nAMD的首选药物，因为它能改善视网膜的解剖参数和视觉功能。
