Banaee Touka, Alwan Shadan, Kellogg Clint, Kornblau Ilyse, El-Annan Jaafar
University of Texas Medical Branch in Galveston, Texas, USA.
University of Texas at MD Anderson, Houston, Texas, USA.
J Ophthalmic Vis Res. 2021 Apr 29;16(2):178-186. doi: 10.18502/jovr.v16i2.9081. eCollection 2021 Apr-Jun.
To report the one and two year outcome of cycles of three, monthly anti-VEGF injections given upon reactivation of the disease in eyes with neovascular age-related macular degeneration (nAMD).
Retrospective study of naïve nAMD cases with more than one year of follow-up, treated with a protocol of cycles of three monthly injections of anti-VEGF drugs upon reactivation. Visual acuity (VA) and central macular thickness (CMT) are the main outcome measures.
Twenty-six patients with a mean age of 78.15 9.29 years (57.7% female) were included. The mean follow-up was 30.89 6.95 months. Treatment started with bevacizumab in all patients but in six patients was switched to aflibercept due to inadequate response to intravitreal bevacizumab injection. The mean VA at baseline and at 12 and 24 months was 53.87 21.84, 60.54 21.13, and 53.68 27.16 ETDRS letters, respectively. Patients gained a mean of 6.67 13.7 ( = 0.013, 95% CI= 0.60 to 12.65) and 0.77 15.21 ( = 0.4, 95% CI: -5.65 to 7.2) letters at 12 and 24 months. CMT at baseline, 12, and 24 months was 403.55 147.59, 323.95 79.58, and 298.59 77.161 µm, respectively. The number of injections in the first and second years were 7.65 2.64 and 5.52 3.01, respectively. Three eyes (12.5%) lost 15 letters at 24 months.
This protocol can stabilize or improve vision in 87.5% of nAMD patients and can reduce the number of visits.
报告在新生血管性年龄相关性黄斑变性（nAMD）患者疾病复发时每月进行三次抗血管内皮生长因子（VEGF）注射，为期一年和两年的治疗效果。
对初治nAMD病例进行回顾性研究，随访时间超过一年，采用疾病复发时每月注射三次抗VEGF药物的治疗方案。主要观察指标为视力（VA）和中心黄斑厚度（CMT）。
纳入26例患者，平均年龄78.15±9.29岁（女性占57.7%）。平均随访时间为30.89±6.95个月。所有患者均从贝伐单抗开始治疗，但6例患者因玻璃体内注射贝伐单抗反应不佳而改用阿柏西普。基线时、12个月和24个月时的平均视力分别为53.87±21.84、60.54±21.13和53.68±27.16 ETDRS字母。患者在12个月和24个月时平均视力分别提高了6.67±13.7（P = 0.013，95%可信区间[CI]= 0.60至12.65）和0.77±15.21（P = 0.4，95%CI：-5.65至7.2）个字母。基线时、12个月和24个月时的CMT分别为403.55±147.59、323.95±79.58和298.59±77.161µm。第一年和第二年的注射次数分别为7.65±2.64次和5.52±3.01次。24个月时，3只眼（12.5%）视力下降≥15个字母。
该方案可使87.5%的nAMD患者视力稳定或提高，并可减少就诊次数。
