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治疗初发新生血管性年龄相关性黄斑变性的 brolucizumab 短期疗效:一项日本多中心研究。

Short-term results for brolucizumab in treatment-naïve neovascular age-related macular degeneration: a Japanese multicenter study.

机构信息

Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan.

Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

出版信息

Jpn J Ophthalmol. 2022 Jul;66(4):379-385. doi: 10.1007/s10384-022-00922-3. Epub 2022 May 21.

Abstract

PURPOSE

To investigate short-term treatment outcomes of intravitreal brolucizumab (IVBr) for treatment-naïve neovascular age-related macular degeneration (AMD) in a Japanese multicenter study.

STUDY DESIGN

Retrospective case control study METHODS: The subjects were 58 eyes of 57 patients with neovascular AMD (43 men and 14 women, mean age 74.6 years) of whom 43 eyes of 42 patients completed initial loading of 3 monthly IVBr injections and were followed for more than 3 months. Best-corrected visual acuity (BCVA) changes, anatomical outcomes, and complications were investigated.

RESULTS

Of the 43 eyes that completed loading doses, the AMD subtype was type 1 and type 2 macular neovascularization (MNV) in 51%, polypoidal choroidal vasculopathy (PCV) in 42%, and type 3 MNV in 7%. At 3 months after initiating treatment, BCVA significantly improved (P = 0.002) and central retinal thickness significantly decreased (P < 0.0001). At 3 months, complete retinal and subretinal fluid resolution was achieved in 91% of all eyes and complete regression of polypoidal lesions was achieved in 82% of PCV eyes. Iritis occurred in 8 eyes of 8 patients (14%), but resolved using topical or subtenon corticosteroid injection without visual loss in all cases.

CONCLUSIONS

IVBr for treatment-naïve neovascular AMD was effective in the short-term, achieving significantly improved BCVA, good retinal fluid resolution, and a high rate of polypoidal lesion regression. However, iritis was noted in 14% of patients which may limit use of this drug.

摘要

目的

研究玻璃体腔内注射布罗利珠单抗(IVBr)治疗初治新生血管性年龄相关性黄斑变性(AMD)的短期治疗效果。

研究设计

回顾性病例对照研究。

方法

本研究共纳入 57 例(58 只眼)初治新生血管性 AMD 患者,其中男 43 例,女 14 例,平均年龄 74.6 岁。43 只眼(42 例)完成了 3 个月的初始负荷剂量治疗,随访时间超过 3 个月。观察最佳矫正视力(BCVA)变化、解剖学结局和并发症。

结果

完成负荷剂量治疗的 43 只眼中,AMD 亚型为 1 型和 2 型黄斑新生血管(MNV)占 51%,息肉状脉络膜血管病变(PCV)占 42%,3 型 MNV 占 7%。治疗开始后 3 个月,BCVA 显著提高(P=0.002),中心视网膜厚度显著降低(P<0.0001)。治疗 3 个月时,所有眼的视网膜和视网膜下积液完全消退率为 91%,PCV 眼的息肉样病变完全消退率为 82%。8 例(14%)患者共 8 只眼出现虹膜炎,但所有患者均通过局部或球后皮质类固醇注射缓解,视力未受影响。

结论

IVBr 治疗初治新生血管性 AMD 短期疗效显著,可显著提高 BCVA,改善视网膜积液,息肉样病变消退率高。然而,14%的患者出现虹膜炎,这可能限制了该药物的使用。

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