Ermenek State Hospital, Ophthalmology Clinic, Karaman, Turkey.
Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Ophthalmology, Afyonkarahisar, Turkey.
Photodiagnosis Photodyn Ther. 2021 Jun;34:102307. doi: 10.1016/j.pdpdt.2021.102307. Epub 2021 May 1.
Evaluation of anatomical and functional recovery of the retina after aflibercept therapy in neovascular age-related macular degeneration.
This prospective study enrolled 33 eyes of 33 naive age-related macular degeneration patients with an average age of 69 (55-82) years. Following a thorough ophthalmological examination, baseline color fundus photography, optical coherence tomography and fluorescein angiography were used to assess the angiographic characteristics and classification of the lesions. Multifocal electroretinography and microperimetry were recorded. In the first three months, all patients received three consecutive intravitreal aflibercept injections on a monthly basis. After the initial three doses, non-responders received additional afibercept injections. The baseline, 3rd and 6th month data were recorded for analysis.
The baseline average best-corrected visual acuity (1.05 log MAR) improved dramatically to 0.9 log MAR in the 3rd and 6th months, respectively. The baseline average central macular thickness of 358.5 ± 232.1 μm decreased significantly to 273.0 ± 109.9 μm and 245.5 ± 109.3 μm in the 3rd and 6th months, respectively. The average thickness of the central 1 mm macular region decreased significantly from 349.5 ± 96.4 μm to the 3rd and 6th month values of 320.6 ± 101.9 and 290.5 ± 86.4 μm, respectively. While the mean retinal sensitivity increased significantly from 4.7 ± 3.0 dB to 6.9 ± 3.4 Db, local deficit decreased from -11.6 ± 4.6 dB to -9.4 ± 4.6 dB. Significant improvements were also observed in all rings of N1 and P1 waves.
Intravitreal aflibercept therapy resulted in significant morphological improvements that were easily identifiable during the 3rd month. Electrophysiological improvements were delayed only to become statistically significant in the 6th month. However, it has been shown that visual acuity and optical coherence tomography parameters alone may be insufficient for both the morphological and functional assessment of the retina.
评估新生血管性年龄相关性黄斑变性经阿柏西普治疗后的视网膜解剖和功能恢复。
本前瞻性研究纳入了 33 名平均年龄为 69 岁（55-82 岁）的初治年龄相关性黄斑变性患者的 33 只眼。在进行全面的眼科检查后，使用眼底彩色照相、光学相干断层扫描和荧光素血管造影评估病变的血管造影特征和分类。记录多焦视网膜电图和微视野检查结果。在最初的三个月中，所有患者每月接受三次连续玻璃体内注射阿柏西普。在最初的三次剂量后，无应答者接受了额外的阿柏西普注射。记录基线、第 3 个月和第 6 个月的数据进行分析。
基线时最佳矫正视力（1.05 对数视力表）平均提高到 0.9 对数视力表，分别在第 3 个月和第 6 个月。基线时平均中央黄斑厚度为 358.5±232.1μm，分别显著降低至第 3 个月和第 6 个月的 273.0±109.9μm 和 245.5±109.3μm。中央 1mm 黄斑区平均厚度从 349.5±96.4μm显著降低至第 3 个月和第 6 个月的 320.6±101.9μm 和 290.5±86.4μm。同时，视网膜平均敏感度从 4.7±3.0dB 显著增加至 6.9±3.4dB，局部缺损从-11.6±4.6dB 降低至-9.4±4.6dB。N1 和 P1 波的所有环的振幅也显著增加。
玻璃体内注射阿柏西普治疗可显著改善形态，在第 3 个月即可轻易识别。电生理改善仅延迟到第 6 个月才变得具有统计学意义。然而，已经表明，视力和光学相干断层扫描参数可能不足以评估视网膜的形态和功能。
