Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, Korea.
Department of Ophthalmology and Visual Science, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Sci Rep. 2019 Feb 14;9(1):2055. doi: 10.1038/s41598-019-38504-y.
This retrospective study was to compare the efficacy of intravitreal injection of ranibizumab and aflibercept for patients with pachychoroid neovasculopathy. 54 eyes were initially treated with 3 monthly loading injections of ranibizumab or aflibercept. Treatment switching from ranibizumab to aflibercept, and aflibercept to photodynamic therapy was done at 3 months in case of incomplete fluid absorption. At 3 months, the rate of complete fluid absorption was significantly higher in the aflibercept-treated group than in the ranibizumab-treated group (82.6% vs 51.6%, p = 0.018). The mean reduction of subfoveal choroidal thickness was significantly greater in the aflibercept group than in the ranibizumab group (-35 µm vs -9 µm, p = 0.013). There was no significant difference between the two groups in terms of visual improvement or decrease in central macular thickness. Complete fluid absorption was achieved after switching from ranibizumab to aflibercept in 13 of 15 eyes (86.7%). Adjunctive photodynamic therapy was required in 6 eyes. In conclusion, treatment mainly with anti-vascular endothelial growth factor effectively improved visual acuity within 12 months (from 20/56 to 20/44 at 3 months and to 20/36 at 12 months). Aflibercept was superior to ranibizumab in achieving dry macula and reducing choroidal thickness at 3 months.
这项回顾性研究旨在比较玻璃体内注射雷珠单抗和阿柏西普治疗肥厚脉络膜新生血管病变患者的疗效。54 只眼最初接受 3 个月的雷珠单抗或阿柏西普负荷剂量注射治疗。如果液体吸收不完全，在第 3 个月时进行从雷珠单抗转换为阿柏西普的治疗转换，以及从阿柏西普转换为光动力疗法。在第 3 个月时，阿柏西普治疗组的完全液体吸收率明显高于雷珠单抗治疗组（82.6%比 51.6%，p=0.018）。阿柏西普组的中心凹下脉络膜厚度平均减少量明显大于雷珠单抗组（-35μm 比-9μm，p=0.013）。两组在视力改善或中心黄斑厚度减少方面无显著差异。在 15 只眼中有 13 只（86.7%）从雷珠单抗转换为阿柏西普后实现了完全液体吸收。6 只眼需要辅助光动力疗法。总之，主要采用抗血管内皮生长因子治疗在 12 个月内有效提高了视力（从第 3 个月的 20/56 提高到 20/44，到第 12 个月的 20/36）。阿柏西普在第 3 个月时达到干性黄斑和减少脉络膜厚度方面优于雷珠单抗。
