Ege University Faculty of Medicine, Department of Ophthalmology, İzmir, Turkey
Turk J Ophthalmol. 2021 Jun 29;51(3):161-168. doi: 10.4274/tjo.galenos.2020.52460.
To evaluate functional and anatomical responses to intravitreal aflibercept (IVA) treatment in newly diagnosed and untreated neovascular age-related macular degeneration (nvAMD) cases and to investigate the effect of baseline lesion characteristics on anatomical responses.
This prospective, cross-sectional study included a series of 139 eyes of 133 patients that were diagnosed with active nvAMD and had not been treated. All eyes were subjected to complete ophthalmological examination, spectral-domain optical coherence tomography and fluorescein angiography, and 42 eyes also underwent indocyanine green angiography. IVA treatment was performed using a "treat and extend" regimen after 3 injections at 4-6 weeks intervals. Anatomical and functional responses at 4 weeks after the last injection were evaluated in eyes that completed 3 injections and the subgroup of eyes that completed 6 IVA injections. The effect of baseline lesion characteristics on IVA treatment results was also investigated.
All 139 eyes included in the study received 3 IVA injections (group 1) and 62 received 6 IVA injections. Both groups showed statistically significant improvement in best-corrected visual acuity (p<0.001 for both). The rate of complete response was 54.6% and 58.0% in groups 1 and 2, respectively. In group 1, the presence of pigment epithelial detachment (PED) and serous PED were identified as negative initial factors (p=0.043, p=0.005, respectively). However, none of the baseline characteristics were significantly associated with anatomical response in group 2.
In our study, it was determined that successful anatomical and functional results were achieved with 3 and 6 doses of IVA in eyes with newly-diagnosed and untreated nvAMD. Among baseline characteristics, the presence of PED and serous PED in particular were found to be factors affecting treatment response negatively.
评估玻璃体内注射阿柏西普（IVA）治疗新诊断和未经治疗的新生血管性年龄相关性黄斑变性（nvAMD）病例的功能和解剖学反应，并研究基线病变特征对解剖学反应的影响。
这是一项前瞻性、横断面研究，纳入了 133 名患者的 139 只眼，这些患者均被诊断为活动期 nvAMD，且未接受治疗。所有患者均接受全面眼科检查、频域光相干断层扫描和荧光素血管造影检查，42 只眼还接受了吲哚青绿血管造影检查。在 4-6 周的间隔内进行 3 次注射后，采用“治疗和扩展”方案进行 IVA 治疗。对完成 3 次注射的眼和完成 6 次 IVA 注射的眼亚组，在最后一次注射后 4 周评估解剖学和功能反应。还研究了基线病变特征对 IVA 治疗结果的影响。
本研究纳入的 139 只眼均接受了 3 次 IVA 注射（第 1 组），62 只眼接受了 6 次 IVA 注射。两组患者最佳矫正视力（BCVA）均有统计学意义的改善（p<0.001）。第 1 组和第 2 组完全反应率分别为 54.6%和 58.0%。在第 1 组中，存在色素上皮脱离（PED）和浆液性 PED 被确定为负面的初始因素（p=0.043，p=0.005）。然而，在第 2 组中，基线特征均与解剖学反应无显著相关性。
在本研究中，我们发现新诊断和未经治疗的 nvAMD 患者接受 3 次和 6 次 IVA 治疗可获得成功的解剖学和功能结果。在基线特征中，PED 和浆液性 PED 的存在被发现是影响治疗反应的负面因素。
