玻璃体内注射阿柏西普治疗厚脉络膜新生血管病的效果：与典型年龄相关性黄斑变性新生血管的比较。
Effects of Intravitreous Aflibercept Injection in Pachychoroid Neovasculopathy: Comparison with Typical Neovascular Age-Related Macular Degeneration.
作者信息
Elfandi Sufian, Ooto Sotaro, Miyata Manabu, Ueda-Arakawa Naoko, Subhi Yousif, Yamashiro Kenji, Tamura Hiroshi, Oishi Akio, Hata Masayuki, Yoshimura Nagahisa, Tsujikawa Akitaka
机构信息
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
出版信息
Clin Ophthalmol. 2021 Apr 13;15:1539-1549. doi: 10.2147/OPTH.S285257. eCollection 2021.
PURPOSE
To compare the 12-month efficacy of intravitreous aflibercept (IVA) injection between eyes with pachychoroid neovasculopathy and neovascular age-related macular degeneration (AMD).
METHODS
Retrospective, comparative case series analysis. Twenty-seven eyes with pachychoroid neovasculopathy and sixty-three eyes with neovascular AMD. All patients received three initial monthly, followed by bimonthly, IVA injections.
RESULTS
Twelve months after initial treatment, the mean best-corrected visual acuity (BCVA) had improved both in pachychoroid neovasculopathy (from 0.28 to 0.14 logMAR; = 0.001) and neovascular AMD (from 0.40 to 0.29 logMAR; < 0.001). Twelve months after initial treatment, eyes with pachychoroid neovasculopathy exhibited decreased mean central retinal thickness (CRT) and subfoveal choroidal thickness (both, < 0.001) and presence of polyps ( = 0.039) and improved integrity of external limiting membrane (ELM) ( = 0.008) and ellipsoid zone band ( = 0.001). At the 12-month follow-up, 77% and 68% of eyes with pachychoroid neovasculopathy and neovascular AMD, respectively, exhibited dry macula ( = 0.30). Baseline CRT was correlated with 12-month BCVA in eyes with pachychoroid neovasculopathy ( = 0.02). In eyes with neovascular AMD, CRT ( = 0.005) and presence of intact ELM ( = 0.007) were significant predictors of 12-month BCVA.
CONCLUSION
Periodic IVA injection leads to anatomical and functional improvement in eyes with pachychoroid neovasculopathy and in eyes with neovascular AMD.
目的
比较玻璃体内注射阿柏西普（IVA）治疗厚脉络膜新生血管病变眼和新生血管性年龄相关性黄斑变性（AMD）眼12个月的疗效。
方法
回顾性、比较性病例系列分析。27例厚脉络膜新生血管病变眼和63例新生血管性AMD眼。所有患者最初每月接受3次，随后每两个月接受1次IVA注射。
结果
初始治疗12个月后，厚脉络膜新生血管病变眼（从0.28降至0.14 logMAR；P = 0.001）和新生血管性AMD眼（从0.40降至0.29 logMAR；P < 0.001）的平均最佳矫正视力（BCVA）均有所改善。初始治疗12个月后，厚脉络膜新生血管病变眼的平均中心视网膜厚度（CRT）和黄斑下脉络膜厚度均降低（均P < 0.001），息肉存在情况改善（P = 0.039），外核层膜（ELM）完整性改善（P = 0.008），椭圆体带完整性改善（P = 0.001）。在12个月随访时，厚脉络膜新生血管病变眼和新生血管性AMD眼分别有77%和68%表现为干性黄斑（P = 0.30）。厚脉络膜新生血管病变眼的基线CRT与12个月时的BCVA相关（P = 0.02）。在新生血管性AMD眼中，CRT（P = 0.005）和完整ELM的存在（P = 0.007）是12个月时BCVA的显著预测因素。
结论
定期注射IVA可使厚脉络膜新生血管病变眼和新生血管性AMD眼在解剖和功能上得到改善。
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