Inoda Satoru, Takahashi Hidenori, Takahashi Ryota, Hashimoto Yuto, Yoshida Hana, Takahashi Hironori, Takayama Takuya, Kawashima Hidetoshi, Yanagi Yasuo
Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, 329-0498, Tochigi, Japan.
Department of Ophthalmology and Micro-Technology, Yokohama City University, Yokohama, Japan.
Ophthalmol Ther. 2023 Oct;12(5):2703-2712. doi: 10.1007/s40123-023-00779-w. Epub 2023 Aug 2.
The aim of this study was to investigate the safety and efficacy of a single injection of intravitreal faricimab (IVF) in patients with neovascular age-related macular degeneration (nAMD) who had a prior treatment history.
A retrospective analysis was conducted on a consecutive cohort of 80 eyes of 75 patients with nAMD who had a prior history of treatment with an injection of anti-vascular endothelial growth factor. Best-corrected visual acuity (BCVA), central subfield thickness (CST), and central choroidal thickness (CCT) were compared before the initial IVF injection and after a treatment interval matching the previous duration.
Central choroidal thickness decreased significantly following the IVF injection, but there was no significant change in BCVA or CST. Mean (± standard deviation) BCVA changed from 0.34 ± 0.37 to 0.36 ± 0.40 (P = 0.29), CST changed from 242 ± 72 to 242 ± 82 µm (P = 0.99), and CCT changed from 189 ± 98 to 179 ± 97 µm (P < 0.0001). When the changes were evaluated according to the previous anti-VEGF agent administered, CCT was found to be significantly decreased by 8.7 ± 2.5 µm (P < 0.0001) in eyes previously treated with brolucizumab and by 13.1 ± 3.6 µm (P < 0.0001) in eyes previously treated with aflibercept. No adverse events were observed during the study period.
Intravitreal faricimab injection is a safe and effective treatment for nAMD in terms of short-term outcomes. Further long-term study is necessary.
本研究的目的是调查单次玻璃体内注射法西单抗（IVF）在有既往治疗史的新生血管性年龄相关性黄斑变性（nAMD）患者中的安全性和有效性。
对75例有抗血管内皮生长因子注射既往治疗史的nAMD患者的80只眼睛进行连续队列回顾性分析。比较初次IVF注射前以及与之前治疗时长相匹配的治疗间隔后的最佳矫正视力（BCVA）、中心子野厚度（CST）和中心脉络膜厚度（CCT）。
IVF注射后中心脉络膜厚度显著降低，但BCVA或CST无显著变化。平均（±标准差）BCVA从0.34±0.37变为0.36±0.40（P = 0.29），CST从242±72变为242±82μm（P = 0.99），CCT从189±98变为179±97μm（P < 0.0001）。根据之前使用的抗VEGF药物评估变化时，发现先前接受布罗卢单抗治疗的眼睛CCT显著降低8.7±2.5μm（P < 0.0001），先前接受阿柏西普治疗的眼睛CCT显著降低13.1±3.6μm（P < 0.0001）。研究期间未观察到不良事件。
就短期结果而言，玻璃体内注射法西单抗是治疗nAMD的一种安全有效的方法。有必要进行进一步的长期研究。
