Fukuda Yoshiko, Sakurada Yoichi, Sugiyama Atsushi, Yoneyama Seigo, Matsubara Mio, Kikushima Wataru, Tanabe Naohiko, Parikh Ravi, Kashiwagi Kenji
Departments of Ophthalmology, Faculty of Medicine, University of Yamanashi, Chuo 409-3898, Yamanashi, Japan.
Department of Ophthalmology, School of Medicine, New York University, New York, NY 10016, USA.
J Clin Med. 2020 Jul 31;9(8):2459. doi: 10.3390/jcm9082459.
We investigated whether responses to as-needed intravitreal aflibercept injections (IAIs) for polypoidal choroidal vasculopathy (PCV) differed among patients based upon drusen characteristics in fellow eyes. 110 eyes from 110 patients with PCV received 3 monthly IAI and thereafter Pro re nata (PRN) IAI over 12 months. Patients were classified into 4 groups depending on fellow eye findings. Group 1 (n = 16): pachydrusen; Group 2 (n = 45): no drusen; Group 3 (n = 35): soft drusen; Group4 (n = 14) PCV/scarring. Best-corrected visual acuity improved at 12 months in all groups, but not significantly in Group 1 and Group 4; however, visual improvement was similar among the groups after adjusting baseline confounders. Group 1 had a significantly lower percentage of eyes needing retreatment (all < 0.001; Group 1: 16.7%; Group 2: 50.8%; Group 3: 80%; Group 4: 85.7%). The mean number of retreatments was least in Group 1 among the groups (all -value < 0.003; Group 1: 0.50 ± 1.32; Group 2: 1.73 ± 2.08; Group 3:2.71 ± 1.99; Group 3: 2.71 ± 2.16). Patients with pachydrusen in fellow eyes were less likely to require additional IAI following the loading dose and may be ideal candidates for aflibercept monotherapy in their first year.
我们调查了基于对侧眼的玻璃膜疣特征，息肉状脉络膜血管病变（PCV）患者对按需玻璃体内注射阿柏西普（IAIs）的反应是否存在差异。110例PCV患者的110只眼接受了为期3个月的每月1次IAI注射，之后在12个月内根据需要进行注射。根据对侧眼的检查结果，患者被分为4组。第1组（n = 16）：厚玻璃膜疣；第2组（n = 45）：无玻璃膜疣；第3组（n = 35）：软性玻璃膜疣；第4组（n = 14）：PCV/瘢痕形成。所有组在12个月时最佳矫正视力均有改善，但第1组和第4组改善不显著；然而，在调整基线混杂因素后，各组间视力改善情况相似。第1组需要再次治疗的眼的百分比显著较低（所有P值< 0.001；第1组：16.7%；第2组：50.8%；第3组：80%；第4组：85.7%）。各组中，第1组的平均再次治疗次数最少（所有P值< 0.003；第1组：0.50±1.32；第2组：1.73±2.08；第3组：2.71±1.99；第3组：2.71±2.16）。对侧眼有厚玻璃膜疣的患者在负荷剂量后需要额外IAI注射的可能性较小，可能是阿柏西普单药治疗第一年的理想候选者。
