National Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
Eye (Lond). 2021 Feb;35(2):409-417. doi: 10.1038/s41433-020-0851-y. Epub 2020 Apr 7.
To evaluate the impact of injection frequency on yearly visual outcomes of patients treated with intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) over a period of 5 years in a tertiary ophthalmic centre.
Single centre, retrospective cohort study.
Consecutive treatment-naive nAMD patients initiated on aflibercept injections 5 years ago.
The Moorfields OpenEyes database was searched for consecutive patients who were initiated on intravitreal aflibercept for nAMD in 2013-14 and the visual acuity (VA) in Early Diabetic Retinopathy Study (ETDRS) letters and injection records per year were recorded for a period of 5 years. Analyses of the whole cohort and a sub-sample of 5-year completers were done. The cohort was further grouped into Group A (on continuous treatment), Group B (early cessation of treatment) and Group C (interrupted treatment) to evaluate the relation between treatment frequency and visual outcomes.
The primary end point was change in VA at 5 years; secondary outcomes included proportion of eyes that gained or maintained VA, number of injections received and the effect of treatment frequency.
Data were collected on 468 patients (512 eyes). Sixty-six percent of the patients completed 5-year follow-up. The mean age of the whole cohort was 79.5 ± 8.5 years and the mean baseline VA was 58.3 ± 15.4 letters. Amongst the completers, final VA change was -2.9 (SD 23.4) ETDRS letters and the cumulative number of injections over 5 years was 24.2 (10.6). Group A had three letter gain and received significantly higher cumulative number of injections over 5 years than Group B and C (31.8, 14.6 and 18.4 respectively, p = 0.001). After adjusting for age and baseline VA, on average, final VA was +8.0 letters higher in the ≥20 injections group than the <20 group (p = 0.001).
Aflibercept therapy results in sustained good visual outcome over 5 years in neovascular AMD eyes when early and persistent treatment is given.
评估在一个三级眼科中心，5 年内注射频率对接受玻璃体腔内阿柏西普治疗新生血管性年龄相关性黄斑变性（nAMD）患者的每年视觉结果的影响。
单中心回顾性队列研究。
5 年前开始接受玻璃体腔内阿柏西普治疗的连续治疗初治 nAMD 患者。
在 Moorfields OpenEyes 数据库中搜索 2013-14 年开始接受玻璃体腔内阿柏西普治疗 nAMD 的连续患者，记录每年的视力（VA）在早期糖尿病视网膜病变研究（ETDRS）字母和注射记录，持续 5 年。对整个队列和 5 年完成者的子样本进行分析。该队列进一步分为 A 组（连续治疗）、B 组（早期停止治疗）和 C 组（中断治疗），以评估治疗频率与视觉结果之间的关系。
主要终点为 5 年时 VA 的变化；次要结局包括 VA 提高或保持的眼数、注射次数和治疗频率的影响。
共收集了 468 名患者（512 只眼）的数据。66%的患者完成了 5 年的随访。整个队列的平均年龄为 79.5±8.5 岁，平均基线 VA 为 58.3±15.4 个字母。在完成者中，最终 VA 变化为-2.9（23.4）个 ETDRS 字母，5 年内累积注射次数为 24.2（10.6）次。A 组有 3 个字母的提高，并且在 5 年内接受了显著更高的累积注射次数，分别比 B 组和 C 组多 31.8、14.6 和 18.4 次（p=0.001）。在校正年龄和基线 VA 后，在平均情况下，20 次以上注射组的最终 VA 比 20 次以下注射组高 8.0 个字母（p=0.001）。
在新生血管性 AMD 眼中，早期和持续治疗阿柏西普治疗可在 5 年内持续获得良好的视觉效果。
