阿柏西普治疗并延长方案下黄斑新生血管的长期形态学变化

LONG-TERM MORPHOLOGIC CHANGES IN MACULAR NEOVASCULARIZATION UNDER AFLIBERCEPT TREATMENT WITH A TREAT-AND-EXTEND REGIMEN.

作者信息

Nakano Yuyako, Takeuchi Jun, Horiguchi Etsuyo, Ota Hikaru, Taki Yosuke, Ito Yasuki, Terasaki Hiroko, Nishiguchi Koji M, Kataoka Keiko

机构信息

Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Ophthalmology, Fujita Health University School of Medicine, Toyoake, Japan; and Department of Ophthalmology, Kyorin University Graduate School of Medicine, Tokyo, Japan.

出版信息

Retina. 2023 Mar 1;43(3):412-419. doi: 10.1097/IAE.0000000000003676.

DOI:10.1097/IAE.0000000000003676

PMID:36730570

Abstract

PURPOSE

To examine the morphologic changes in macular neovascularization (MNV) secondary to age-related macular degeneration after 2 years of aflibercept treatment under a treat-and-extend (T&E) regimen.

METHODS

This retrospective study analyzed the medical records for 26 eyes of 25 patients diagnosed with treatment-naive neovascular age-related macular degeneration and treated with aflibercept under a treat-and-extend regimen for 2 years. The areas of the MNV and vascular structures were assessed using swept-source optical coherence tomography angiography at baseline and after 2 years of treatment.

RESULTS

The mean MNV area increased significantly from 0.65 ± 0.42 mm 2 at baseline to 0.78 ± 0.45 mm 2 at 2 years. At 2 years, the mean change in the MNV area from baseline was 22% (interquartile range: 4%-60%). The baseline MNV area was negatively correlated with the change ratio of the MNV areas at 2 years and baseline ( R = -0.68, P < 0.001). Nine of the 26 eyes (34.6%) showed newly formed mature vessels, and 7 eyes (26.9%) showed prominently developing preexisting mature vessels.

CONCLUSION

Macular neovascularization expanded and showed vascular maturation under aflibercept treatment with a treat-and-extend regimen. The smaller the MNV at baseline, the greater is its expansion in 2 years.

摘要

目的

在治疗并延长（T&E）方案下，研究阿柏西普治疗2年后年龄相关性黄斑变性继发黄斑新生血管（MNV）的形态学变化。

方法

这项回顾性研究分析了25例初治新生血管性年龄相关性黄斑变性患者的26只眼睛的病历，这些患者在治疗并延长方案下接受阿柏西普治疗2年。在基线期和治疗2年后，使用扫频源光学相干断层扫描血管造影术评估MNV和血管结构的面积。

结果

MNV平均面积从基线时的0.65±0.42mm²显著增加到2年时的0.78±0.45mm²。在2年时，MNV面积相对于基线的平均变化为22%（四分位间距：4%-60%）。基线MNV面积与2年时和基线时MNV面积的变化率呈负相关（R=-0.68，P<0.001）。26只眼中有9只（34.6%）出现新形成的成熟血管，7只眼（26.9%）显示原有成熟血管显著发展。