Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.
Department of Ophthalmology, International University of Health and Welfare, Narita, Japan.
J Diabetes Res. 2021 Feb 12;2021:1374891. doi: 10.1155/2021/1374891. eCollection 2021.
The purpose of this study was to compare the efficacies of one initial intravitreal injection of aflibercept followed by a (PRN; 1+PRN) regimen to those of three consecutive monthly injections followed by the PRN (3+PRN) regimen for diabetic macular edema (DME) with practical protocols. The medical records of 95 eyes of 71 cases that were diagnosed with DME and had received intravitreal aflibercept (IVA) injections were reviewed. Fifty-seven eyes had received IVA with the 1+PRN regimen, and 38 eyes had received IVA with the 3+PRN regimen. The best-corrected visual acuity (BCVA) and the central macular thickness (CMT) were measured at the baseline and at 1, 3, 6, and 12 months after the IVA. The mean number of injections of the 1+PRN group was 2.9 ± 1.7, which was significantly fewer than that of the 3+PRN group at 4.6 ± 1.4 ( < 0.001). The change of the mean BCVA before and after the IVA at 12 months of the 3+PRN group was -0.14 ± 0.17 logMAR units which was significantly better than that of the 1+PRN group of -0.045 ± 0.25 logMAR units ( = 0.02). The change of the CMT before and after the IVA at 6 months of the 3+PRN group was -141.3 ± 152.4 m which was significantly more than that of the 1+PRN group at -86.1 ± 117.8 m ( = 0.013). Although the mean number of injections was more than that in the 1+PRN regimen, the 3+PRN regimen had better visual outcomes at 12 months. In a practical protocol, we recommend the 3+PRN regimen for patients with DME (IRB#3541).
本研究旨在比较两种治疗方案对糖尿病黄斑水肿（DME）的疗效，一种是玻璃体腔内单次注射阿柏西普（Aflibercept）后采用（PRN；1+PRN）方案，另一种是连续三个月每月注射阿柏西普后采用 PRN（3+PRN）方案，所有方案均采用实际方案。回顾性分析 71 例（95 只眼）接受玻璃体腔内注射阿柏西普治疗的 DME 患者的病历资料。57 只眼采用 1+PRN 方案，38 只眼采用 3+PRN 方案。在基线和玻璃体腔内注射后 1、3、6 和 12 个月测量最佳矫正视力（BCVA）和中心黄斑厚度（CMT）。1+PRN 组的平均注射次数为 2.9±1.7 次，明显少于 3+PRN 组的 4.6±1.4 次（<0.001）。3+PRN 组治疗 12 个月后平均 BCVA 变化为-0.14±0.17 logMAR 单位，明显优于 1+PRN 组的-0.045±0.25 logMAR 单位（=0.02）。3+PRN 组治疗 6 个月后 CMT 的变化为-141.3±152.4μm，明显大于 1+PRN 组的-86.1±117.8μm（=0.013）。虽然 3+PRN 组的平均注射次数多于 1+PRN 组，但在 12 个月时，3+PRN 组的视力结果更好。在实际方案中，我们推荐 3+PRN 方案用于治疗 DME 患者（IRB#3541）。
