Adrean Sean D, Knight Darren, Chaili Siyang, Ramkumar Hema L, Pirouz Ash, Grant Scott
Retina Consultants of Orange County, 301 W. Bastanchury Ave #285, Fullerton, CA, 92835, USA.
University of California San Diego, Shiley Eye Institute, La Jolla, CA, 92093, USA.
Int J Retina Vitreous. 2022 Feb 10;8(1):11. doi: 10.1186/s40942-022-00361-9.
This study explores the long term anatomic and functional results of patients who were switched to intravitreal aflibercept injections (IAI) after being initially managed with other anti-VEGF agents for neovascular age-related macular degeneration (nAMD).
Patients with nAMD were included if they started with another anti-VEGF agent and were switched to IAI. Subjects had at least 3 years of consistent therapy with IAI and at least 1 injection quarterly.
Eighty-eight patients had at least 3 years of treatment while 58 of those patients, had at least 4 years of IAI. Average treatment time with other anti-VEGF agents was 32 months prior to switching. Baseline best corrected vision (VA) was 59.4 letters (20/70 + 2). At time of switch, VA increased significantly to 66.7 letters (20/50 + 2). At 3 months after switch, VA increased significantly to 69.0 (20/40-) letters. After 3 years of consistent IAI, vision was 67.5 letters (20/40-2), and for those patients that completed 4 years of therapy, the average VA was 66.0 letters (20/50 + 2), with a gain of 6.6 letters over baseline vision. 32.1% of patients gained 3 or more lines of vision. Initial central macular thickness (CMT) was 369 µm, which improved to 347 µm at time of switch, and further improved at 3 months to 301 µm and was maintained over time.
Patients switched to IAI can maintain vision over the long term. Patients treated on average for 5.7 years, had a visual gain of 8.1 letters after 3 years and 6.6 letters after 4 years of IAI therapy. CMT significantly improved following the switch and was maintained.
本研究探讨了在最初使用其他抗血管内皮生长因子（VEGF）药物治疗新生血管性年龄相关性黄斑变性（nAMD）后转而接受玻璃体内注射阿柏西普（IAI）治疗的患者的长期解剖学和功能结果。
纳入最初使用其他抗VEGF药物治疗后转而接受IAI治疗的nAMD患者。受试者接受IAI持续治疗至少3年，且每季度至少注射1次。
88例患者接受治疗至少3年，其中58例患者接受IAI治疗至少4年。转而接受IAI治疗前，使用其他抗VEGF药物的平均治疗时间为32个月。基线最佳矫正视力（VA）为59.4个字母（20/70 +2）。转而接受IAI治疗时，VA显著提高至66.7个字母（20/50 +2）。转而接受IAI治疗3个月后，VA显著提高至69.0（20/40-）个字母。经过3年持续的IAI治疗后，视力为67.5个字母（20/40-2），对于完成4年治疗的患者，平均VA为66.0个字母（20/50 +2），比基线视力提高了6.6个字母。32.1%的患者视力提高了3行或更多行。初始中心黄斑厚度（CMT）为369μm，转而接受IAI治疗时改善至347μm，3个月时进一步改善至301μm，并随时间维持。
转而接受IAI治疗的患者可长期维持视力。平均接受5.7年治疗的患者，在接受IAI治疗3年后视力提高了8.1个字母，4年后提高了6.6个字母。转而接受IAI治疗后CMT显著改善并维持。
