Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3821, Japan.
Jpn J Ophthalmol. 2023 Jul;67(4):402-409. doi: 10.1007/s10384-023-00999-4. Epub 2023 Jun 8.
To compare the one-year visual and anatomic outcomes of an as-needed regimen of brolucizumab and aflibercept for polypoidal choroidal vasculopathy (PCV).
A retrospective comparative study.
A retrospective medical chart review was performed for consecutive 56 eyes from 56 patients with PCV initially treated with thee monthly intravitreal aflibercept (n = 33, 2.0 mg/0.05 ml) or brolucizumab (n = 23, 6.0 mg/0.05 ml) followed by as-needed administration, followed up for at least 12 months. All patients were followed up monthly, and fluorescein and indocyanine green angiography (ICGA) were performed at baseline, 3-month, and 12-month visits.
At the 12-month visit, best-corrected visual acuity significantly improved from 0.30 ± 0.31 to 0.21 ± 0.29 (p = 0.042) in the brolucizumab-treated group and from 0.24 ± 0.25 to 0.14 ± 0.25 (p = 7.7×10) in the aflibercept-treated group, suggesting comparable visual improvement in both groups. Central retinal thickness and subfoveal choroidal thickness decreased by 38.4% and 14.2%, respectively, in the brolucizumab-treated group and by 34.8% and 13.9%, respectively, in the aflibercept-treated group at the 12-month visit. The mean number of additional injections was significantly higher in the aflibercept-treated group (2.9 ± 2.7) than in the brolucizumab-treated group (1.3 ± 1.2, p = 0.045). The complete resolution of polypoidal lesions on ICGA was higher in the brolucizumab-treated group than in the aflibercept-treated group (3-month visit: 56.5% vs 30.3%, 12-month visit: 56.5% vs 30.3%).
In treatment-naïve eyes with PCV, the as-needed administration regimen of brolucizumab was comparable to aflibercept in terms of visual and anatomical outcomes, with fewer additional injections during the 12-month follow-up.
比较按需给予布罗利珠单抗和阿柏西普治疗息肉状脉络膜血管病变（PCV）的一年视觉和解剖结果。
回顾性比较研究。
对 56 例 56 只眼 PCV 患者的连续病历进行回顾性医学图表审查，这些患者最初分别接受了 3 个月的玻璃体腔内阿柏西普（n=33，2.0mg/0.05ml）或布罗利珠单抗（n=23，6.0mg/0.05ml）治疗，然后进行按需给药，至少随访 12 个月。所有患者均每月随访，在基线、3 个月和 12 个月时进行荧光素和吲哚青绿血管造影（ICGA）检查。
在 12 个月的随访中，布罗利珠单抗治疗组的最佳矫正视力从 0.30±0.31 显著提高至 0.21±0.29（p=0.042），阿柏西普治疗组从 0.24±0.25 提高至 0.14±0.25（p=7.7×10），提示两组的视力改善相当。布罗利珠单抗治疗组在 12 个月时中央视网膜厚度和中心凹下脉络膜厚度分别下降了 38.4%和 14.2%，阿柏西普治疗组分别下降了 34.8%和 13.9%。布罗利珠单抗治疗组（2.9±2.7）的追加注射次数明显高于阿柏西普治疗组（1.3±1.2，p=0.045）。布罗利珠单抗治疗组在 ICGA 上息肉样病变完全消退的比例高于阿柏西普治疗组（3 个月：56.5%比 30.3%，12 个月：56.5%比 30.3%）。
在未经治疗的 PCV 眼中，布罗利珠单抗的按需给药方案在视觉和解剖结果方面与阿柏西普相当，在 12 个月的随访中需要更少的追加注射。
