Department of Ophthalmology, University of Health Sciences, Beyoglu Eye Training and Research Hospital, Bereketzade Mah, Bereketzade Sok No 2, Beyoğlu, 34421, İstanbul, Turkey.
School of Medicine Department of Ophthalmology, Acibadem University, Istanbul, Turkey.
Int Ophthalmol. 2021 Jun;41(6):1989-2000. doi: 10.1007/s10792-021-01754-9. Epub 2021 Mar 2.
PURPOSE: To evaluate anatomical and visual outcomes in patients who received intravitreal anti-vascular endothelial growth factor (VEGF) agents in combination with full-dose photodynamic therapy (PDT) on eyes with choroidal neovascularization (CNV) secondary to naive pachychoroid neovasculopathy (PNV). MATERIALS AND METHODS: Medical records on 19 eyes of 19 patients whom intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR), and intravitreal aflibercept (IVA) injections were administered for CNV caused by PNV were enrolled into the study. The central macular thickness (CMT), best-corrected visual acuity (BCVA), and subfoveal choroidal thickness (SFCT) were recorded at the baseline, months 1, 3, 6, 12, and final control visit following treatment. RESULTS: The age average was 53.84 ± 5.23 years (range, 46-62 years), and mean follow-up time was 33.42 ± 9.43 months (range, 16-49 months). The change in BCVA was found statistically significant in the IVA group only during follow-up visits (p = 0.007). Although there was no statistically significant change in CMT following IVR (360.60 ± 75.64-252 ± 75.04 µm) (p = 0.077), significant changes were observed in IVB (397.14 ± 122.59-275.28 ± 63.82 µm) (p = 0.004) and IVA (385.85 ± 43.82-244.42 ± 51.57 µm) (p = 0.005) between the baseline and the final visit. SFCT significantly decreased following both IVR and IVA treatments (p = 0.016, p = 0.039, respectively). In consideration of the number of injections, significantly fewer injections were needed in the IVA group than the others (p = 0.018). CONCLUSIONS: Anti-VEGF agents with full-dose PDT were well tolerated for the first 3 months and were highly effective treatment option in order to naive PNV patients. However, in long-term follow-ups, the effectiveness of IVA was superior to other anti-VEGFs.
目的:评估接受全剂量光动力疗法(PDT)联合玻璃体内抗血管内皮生长因子(VEGF)药物治疗的脉络膜新生血管(CNV)患者的解剖学和视觉结果,这些患者患有原发性肥厚性脉络膜血管病变(PNV)继发的 CNV。
材料和方法:本研究纳入了 19 名患者的 19 只眼,这些患者因 PNV 导致的 CNV 接受了玻璃体内贝伐单抗(IVB)、玻璃体内雷珠单抗(IVR)和玻璃体内阿柏西普(IVA)注射。在治疗后,分别在基线、第 1、3、6、12 个月和最终随访时记录中央黄斑厚度(CMT)、最佳矫正视力(BCVA)和中心凹下脉络膜厚度(SFCT)。
结果:患者年龄平均为 53.84±5.23 岁(范围 46-62 岁),平均随访时间为 33.42±9.43 个月(范围 16-49 个月)。仅在 IVA 组中,BCVA 的变化在随访期间具有统计学意义(p=0.007)。尽管 IVR 后 CMT 无统计学意义的变化(360.60±75.64-252±75.04 µm)(p=0.077),但在 IVB(397.14±122.59-275.28±63.82 µm)(p=0.004)和 IVA(385.85±43.82-244.42±51.57 µm)(p=0.005)中观察到显著变化。与基线相比,SFCT 在 IVR 和 IVA 治疗后均显著降低(p=0.016,p=0.039)。考虑到注射次数,IVA 组的注射次数明显少于其他组(p=0.018)。
结论:全剂量 PDT 联合抗 VEGF 药物在前 3 个月耐受良好,是治疗原发性 PNV 患者的有效治疗选择。然而,在长期随访中,IVA 的疗效优于其他抗 VEGFs。
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