Hospices Civils de Lyon, Centre Hospitalier Universitaire de la Croix-Rousse, Service d'Ophtalmologie, France.
Université Lyon 1, Lyon, France.
Retina. 2022 Feb 1;42(2):290-297. doi: 10.1097/IAE.0000000000003310.
To evaluate the mean change in visual acuity at 52 weeks in patients with idiopathic choroidal neovascularization treated with aflibercept.
We conducted a prospective noncomparative open-label Phase-II trial. The dosage regimen evaluated in this study was structured into two periods: (1) from inclusion to 20 weeks: a treat-and-extend period composed of three mandatory intravitreal injections, and complementary intravitreal injections performed if needed; (2) from 21 weeks to 52 weeks: a pro re nata period composed of intravitreal injections performed only if needed.
A total of 19 patients were included, and 16 completed the 52-week study. At baseline, the mean best corrected visual acuity was 66.56 (±20.72) letters (≈20/50 Snellen equivalent), and the mean central retinal thickness was 376.74 µm (±93.77). At 52 weeks, the mean change in the best-corrected visual acuity was +19.50 (±19.36) letters [95% confidence interval = +9.18 to +29.82]. None of the patients included lost ≥15 letters at 24 weeks or 52 weeks. The mean change in central retinal thickness was -96.78 µm (±104.29) at 24 weeks and -86.22 µm (±112.27) at 52 weeks. The mean number of intravitreal injections was 5.4 (±3.0) at 52-weeks. No ocular serious adverse events related to the treatment were reported.
The present analysis shows clinically significant functional and anatomical treatment effect of aflibercept in case of idiopathic choroidal neovascularization. The treat-and-extend regimen proposed after the first injection seems adequate to treat most neovessels.
评估玻璃体内注射阿柏西普治疗特发性脉络膜新生血管患者 52 周时的视力平均变化。
我们进行了一项前瞻性、非对照、开放标签的 II 期临床试验。本研究评估的剂量方案分为两个时期:(1)纳入至 20 周:包括三次强制性玻璃体内注射的治疗和扩展期,如有需要可进行补充玻璃体内注射;(2)从 21 周至 52 周:按需进行的 pro re nata 期。
共纳入 19 例患者,16 例完成了 52 周的研究。基线时,平均最佳矫正视力为 66.56(±20.72)个字母(≈20/50 斯耐伦等效视力),平均中心视网膜厚度为 376.74µm(±93.77)。52 周时,最佳矫正视力的平均变化为+19.50(±19.36)个字母[95%置信区间=+9.18 至+29.82]。在 24 周和 52 周时,没有患者视力丧失≥15 个字母。24 周时中央视网膜厚度的平均变化为-96.78µm(±104.29),52 周时为-86.22µm(±112.27)。52 周时平均玻璃体内注射次数为 5.4(±3.0)次。未报告与治疗相关的任何眼部严重不良事件。
本分析显示玻璃体内注射阿柏西普治疗特发性脉络膜新生血管的功能和解剖学治疗效果具有临床意义。首次注射后提出的治疗和扩展方案似乎足以治疗大多数新生血管。