Ozkaya Abdullah, Demir Gokhan, Kirmaci Asli
Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
Eur J Ophthalmol. 2020 Mar;30(2):363-369. doi: 10.1177/1120672119827855. Epub 2019 Feb 13.
To compare the efficacy of ranibizumab and aflibercept in the treatment of diabetic macular edema associated with subfoveal retinal detachment.
This is a retrospective, comparative study. The treatment-naïve diabetic macular edema patients who had diabetic macular edema associated with subfoveal retinal detachment and underwent intravitreal aflibercept or intravitreal ranibizumab treatment were included. The patients were treated on a pro re nata treatment regimen after a loading dose of 3-monthly injections and the follow-up time was 12 months. The primary outcome measure of this study was the presence of subfoveal retinal detachment after treatment at different time points. The secondary outcome measures were the change in best corrected visual acuity and central retinal thickness.
A total of 46 eyes of 46 patients were included. The aflibercept group consisted of 20 and the ranibizumab group consisted of 26 eyes. During the follow-up period of 12 months, subfoveal retinal detachment was completely resolved in 75% versus 57.7% of the eyes at month 3 (p = 0.2), 90% versus 76.9% at month 6 (p = 0.2), 90% versus 65.4% at month 9 (p = 0.05), and 100% versus 80.8% at month 12 (p = 0.03) in the intravitreal aflibercept versus intravitreal ranibizumab groups. The change in best corrected visual acuity was not statistically different between the groups at months 3, 6, 9, and 12, respectively (p > 0.05 for all).
Both intravitreal aflibercept and intravitreal ranibizumab were effective in regards to anatomical and functional outcomes of diabetic macular edema patients associated with subfoveal retinal detachment. Interestingly, intravitreal aflibercept seemed more effective than intravitreal ranibizumab in the resolution of subfoveal retinal detachment at month 12.
比较雷珠单抗和阿柏西普治疗伴有黄斑中心凹下视网膜脱离的糖尿病性黄斑水肿的疗效。
这是一项回顾性比较研究。纳入初治的伴有黄斑中心凹下视网膜脱离且接受玻璃体内注射阿柏西普或玻璃体内注射雷珠单抗治疗的糖尿病性黄斑水肿患者。患者在给予3个月一次的负荷剂量注射后按需治疗，随访时间为12个月。本研究的主要结局指标是不同时间点治疗后黄斑中心凹下视网膜脱离的情况。次要结局指标是最佳矫正视力和中心视网膜厚度的变化。
共纳入46例患者的46只眼。阿柏西普组20只眼，雷珠单抗组26只眼。在12个月的随访期内，玻璃体内注射阿柏西普组与玻璃体内注射雷珠单抗组相比，黄斑中心凹下视网膜脱离在第3个月时完全消退的眼数分别为75%和57.7%（p = 0.2），第6个月时为90%和76.9%（p = 0.2），第9个月时为90%和65.4%（p = 0.05），第12个月时为100%和80.8%（p = 0.03）。在第3、6、9和12个月时，两组间最佳矫正视力的变化无统计学差异（所有p均>0.05）。
玻璃体内注射阿柏西普和玻璃体内注射雷珠单抗对于伴有黄斑中心凹下视网膜脱离的糖尿病性黄斑水肿患者的解剖和功能结局均有效。有趣的是，在第12个月时，玻璃体内注射阿柏西普在消退黄斑中心凹下视网膜脱离方面似乎比玻璃体内注射雷珠单抗更有效。
