伴有良好视力的息肉样脉络膜血管病变的阿柏西普治疗一年的结果。
One-year Results of Aflibercept Treatment for Polypoidal Choroidal Vasculopathy with Good Visual Acuity.
机构信息
Department of Ophthalmology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.
出版信息
Korean J Ophthalmol. 2021 Feb;35(1):26-36. doi: 10.3341/kjo.2020.0096. Epub 2020 Dec 11.
PURPOSE
To evaluate the one-year efficacy of intravitreal aflibercept injection in polypoidal choroidal vasculopathy (PCV) with best-corrected visual acuity (BCVA) of 20 / 40 or better.
METHODS
This was a multicenter retrospective study. The medical records of patients diagnosed with treatment-naïve PCV were retrospectively reviewed. Patients with an initial BCVA of 20 / 40 or better and who had undergone intravitreal aflibercept injection were included. Patients were treated with three consecutive monthly injections, followed by pro re nata regimen according to the clinician's discretion at variable interval visits. The proportions of eyes for which BCVA was maintained (≤ 0.2 logarithm of the minimum angle of resolution change) or improved at 12 months were evaluated. The changes of BCVA, central subfield macular thickness (CSMT), pigment epithelial detachment, and subretinal fluid also were assessed.
RESULTS
A total of 86 eyes were included. The mean number of injections for 12 months of treatment was 5.4 ± 1.7. BCVA was maintained or improved in 94.2% (81 / 86) of cases. Mean BCVA (logarithm of the minimum angle of resolution) had changed from the baseline (0.23 ± 0.09) at 3 months (0.21 ± 0.14), 6 months (0.24 ± 0.22), and 12 months (0.20 ± 0.18), but with no statistical significance. CSMT had improved significantly from the baseline (336.1 ± 97.3 μm) at 3 months (223.6 ± 47.22 μm), 6 months (239.6 ± 64.2 μm), and 12 months (223.8 ± 47.9 μm). Pigment epithelial detachment was observed in 93% of cases at the baseline, 72.1% at 3 months, and 69.8% at 12 months, showing a significant decrease at all observation points. Subretinal fluid was observed in 91.9% of cases at the baseline, 20.9% at 3 months, and 29.1% at 12 months, showing a significant decrease at all observation points.
CONCLUSIONS
In cases of PCV with good visual acuity, intravitreal aflibercept injections decreased CSMT and were effective in maintaining visual acuity.
目的
评估玻璃体内注射阿柏西普治疗最佳矫正视力（BCVA）为 20 / 40 或更好的息肉样脉络膜血管病变（PCV）的一年疗效。
方法
这是一项多中心回顾性研究。回顾性分析了诊断为初治 PCV 且初始 BCVA 为 20 / 40 或更好的患者的病历。纳入接受了玻璃体内注射阿柏西普治疗的患者。这些患者接受了 3 次连续的每月注射治疗，随后根据临床医生的判断，在不同的随访间隔进行了按需治疗。评估了 12 个月时 BCVA 保持（≤ 0.2 最小角分辨率对数变化）或改善的眼比例。还评估了 BCVA、中心视网膜下厚度（CSMT）、色素上皮脱离和视网膜下积液的变化。
结果
共纳入 86 只眼。治疗 12 个月的平均注射次数为 5.4 ± 1.7。94.2%（81 / 86）的病例 BCVA 保持或改善。平均 BCVA（最小角分辨率对数）在 3 个月（0.21 ± 0.14）、6 个月（0.24 ± 0.22）和 12 个月（0.20 ± 0.18）时与基线相比发生了变化，但无统计学意义。CSMT 与基线相比（336.1 ± 97.3μm）在 3 个月（223.6 ± 47.22μm）、6 个月（239.6 ± 64.2μm）和 12 个月（223.8 ± 47.9μm）时显著改善。基线时观察到 93%的病例存在色素上皮脱离，3 个月时为 72.1%，12 个月时为 69.8%，所有观察点均显著减少。基线时观察到 91.9%的病例存在视网膜下积液，3 个月时为 20.9%，12 个月时为 29.1%，所有观察点均显著减少。
结论
在视力良好的 PCV 病例中，玻璃体内注射阿柏西普可降低 CSMT，并有助于维持视力。
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