Ueda-Consolvo Tomoko, Tanigichi Aya, Numata Ayaka, Oiwake Toshihiko, Nakamura Tomoko, Ishida Masaaki, Yanagisawa Shuichiro, Hayashi Atsushi
Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Graefes Arch Clin Exp Ophthalmol. 2023 Feb;261(2):345-352. doi: 10.1007/s00417-022-05793-5. Epub 2022 Aug 10.
To assess the effect of switching to brolucizumab from aflibercept on eyes with type 1 macular neovascularization (MNV) and polypoidal choroidal vasculopathy (PCV) at 18 months.
This study was a retrospective, observational case series that included 19 eyes of 19 patients with type 1MNV and 23 eyes of 22 patients with PCV. We compared the injection intervals, visual acuity, total lesion size, and the number of polypoidal lesions between baseline and 18 months. The correlations between the data including treatment interval, total lesion size, and the number of polyps were also assessed.
Treatment intervals were significantly extended; from 7.4 ± 1.4 weeks to 11.6 ± 2.6 weeks for type 1 MNV, p < 0.001; from 6.9 ± 1.3 to 11.7 ± 3.1 weeks for PCV, p < 0.001. In type 1 MNV eyes, strong correlation was found between total lesion size and brolucizumab injection intervals (r = - 0.81; p = 0.0002) and moderate correlation was found between treatment frequency with aflibercept and that with brolucizumab (r = 0.76; p = 0.040). In PCV eyes, we found strong correlation between the number of polyps and brolucizumab treatment frequency (r = - 0.81; p = 0.0016) and moderate correlation between total lesion size and brolucizumab treatment interval (r = - 0.48; p = 0.034). Intraocular inflammation occurred in 2 of 19 eyes (10.3%) with type 1 MNV and 5 of 23 eyes (21.7%) with PCV.
The properties to extend brolucizumab injection intervals might be the smaller lesion size and lower aflibercept frequency for type 1 MNV and the smaller number of polyps and the smaller size of lesion for PCV.
评估18个月时从阿柏西普转换为布罗利珠单抗对1型黄斑新生血管（MNV）和息肉样脉络膜血管病变（PCV）患眼的影响。
本研究为一项回顾性观察病例系列研究，纳入了19例1型MNV患者的19只眼和22例PCV患者的23只眼。我们比较了基线和18个月时的注射间隔、视力、总病变大小以及息肉样病变数量。还评估了包括治疗间隔、总病变大小和息肉数量在内的数据之间的相关性。
治疗间隔显著延长；1型MNV从7.4±1.4周延长至11.6±2.6周，p<0.001；PCV从6.9±1.3周延长至11.7±3.1周，p<0.001。在1型MNV患眼中，总病变大小与布罗利珠单抗注射间隔之间存在强相关性（r=-0.81；p=0.0002），阿柏西普治疗频率与布罗利珠单抗治疗频率之间存在中度相关性（r=0.76；p=0.040）。在PCV患眼中，息肉数量与布罗利珠单抗治疗频率之间存在强相关性（r=-0.81；p=0.0016），总病变大小与布罗利珠单抗治疗间隔之间存在中度相关性（r=-0.48；p=0.034）。19例1型MNV患眼中有2例（10.3%）发生眼内炎症，23例PCV患眼中有5例（21.7%）发生眼内炎症。
对于1型MNV，延长布罗利珠单抗注射间隔的特性可能是病变较小和阿柏西普使用频率较低；对于PCV，可能是息肉数量较少和病变较小。
