Takamura Yoshihiro, Kida Teruyo, Noma Hidetaka, Inoue Makoto, Yoshida Shigeo, Nagaoka Taiji, Noda Kousuke, Yamada Yutaka, Morioka Masakazu, Gozawa Makoto, Matsumura Takehiro, Inatani Masaru
Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan.
Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan.
J Clin Med. 2021 Dec 8;10(24):5738. doi: 10.3390/jcm10245738.
Pro re nata (PRN) regimen using anti-vascular endothelial growth factor (VEGF) agent is popular for the treatment of diabetic macular edema (DME). We investigated the influence of waiting time (WT) and interval between the date of recurrence of edema and re-injection on treatment efficacy.
This retrospective study conducted at 7 sites in Japan enrolled patients who received intravitreal injection of ranibizumab (IVR) and aflibercept (IVA) in 1+PRN regimen. Enrolled patients were divided into 2 groups: prompt group (less than 1 week) and deferred group (3 weeks or more). Central retinal thickness (CRT) and best corrected visual acuity (BCVA) were measured every month for 1 year.
CRT in the deferred group was significantly higher than that in the prompt group at 2, 5, 6, 7, and 12 months ( < 0.05). BCVA in the prompt group was significantly better than that in the deferred group at 7, 10, and 12 months ( < 0.05).
The prompt group was superior in anatomical and functional improvement of DME in anti-VEGF therapy than the deferred group. Our data suggests that shorter WT is recommended for better visual prognosis in the treatment for DME.
使用抗血管内皮生长因子（VEGF）药物的按需（PRN）治疗方案在糖尿病性黄斑水肿（DME）治疗中很常用。我们研究了等待时间（WT）以及水肿复发日期与再次注射之间的间隔对治疗效果的影响。
这项在日本7个地点进行的回顾性研究纳入了接受玻璃体内注射雷珠单抗（IVR）和阿柏西普（IVA）按需治疗方案的患者。纳入患者分为两组：及时组（少于1周）和延迟组（3周或更长时间）。连续1年每月测量中心视网膜厚度（CRT）和最佳矫正视力（BCVA）。
延迟组在第2、5、6、7和12个月时的CRT显著高于及时组（<0.05）。及时组在第7、10和12个月时的BCVA显著优于延迟组（<0.05）。
在抗VEGF治疗中，及时组在DME的解剖和功能改善方面优于延迟组。我们的数据表明，对于DME治疗，建议缩短等待时间以获得更好的视力预后。
