法布雷单抗治疗既往治疗的新生血管性年龄相关性黄斑变性患者的临床结局。
Clinical Outcomes of Faricimab in Patients with Previously Treated Neovascular Age-Related Macular Degeneration.
机构信息
The Retina Service of Wills Eye Hospital, Wills Eye Physicians - Mid Atlantic Retina, Philadelphia, Pennsylvania.
Sidney Kimmel Medical College at Thomas Jefferson University, Department of Medicine, Philadelphia, Pennsylvania.
出版信息
Ophthalmol Retina. 2024 Apr;8(4):360-366. doi: 10.1016/j.oret.2023.10.018. Epub 2023 Oct 31.
PURPOSE
To assess the anatomic and functional outcomes in eyes with neovascular age-related macular degeneration (nAMD) previously treated with anti-VEGF therapy in response to intravitreal faricimab.
DESIGN
Retrospective, interventional, consecutive case series.
SUBJECTS
Patients with previously treated nAMD who received ≥ 4 consecutive injections of faricimab were included. The study period was from March through November 2022.
METHODS
Clinical and imaging data were extracted from the electronic medical record. Central foveal thickness (CFT), maximum fibrovascular pigment epithelial detachment (fvPED) height, and Snellen visual acuity (VA) were obtained. Generalized estimating equations were used to analyze the change in CFT, maximum fvPED height, and logarithm of the minimum angle of resolution VA.
MAIN OUTCOME MEASURES
Change in CFT, maximum fvPED height, and Snellen VA before faricimab and after ≥ 4 faricimab intravitreal injections.
RESULTS
During the study period, 218 eyes of 191 patients met inclusion criteria. Mean age was 79.9 (range, 70.6-89.2) years. The mean number of intravitreal anti-VEGF injections received before faricimab was 34.2 (range, 6.4-62). The following results were found after ≥ 4 faricimab injections. Mean logarithm of the minimum angle of resolution VA before switching to faricimab was 0.58 (Snellen VA ∼20/76; range, 20/22-20/264) and was 0.55 (Snellen VA ∼20/71; range, 20/21-20/235; P = 0.20) after switching. Mean maximum fvPED height was 195.0 (range, 50.2-339.8) μm before switching to faricimab and improved to 165.0 (range, 33.6-296.4; P < 0.001) μm after switching. Mean CFT was 354.8 (range, 184.7-524.9) μm before switching to faricimab and improved to 306.6 (range, 144.4-468.8; P < 0.001) after switching. The proportion of eyes with intraretinal fluid was 36.7% (80/218 eyes) before switching, and decreased to 24.8% (54/218 eyes, P < 0.001) after switching. The proportion of eyes with subretinal fluid was 53.2% (116/218 eyes) before switching and decreased to 26.6% (58/218 eyes, P < 0.001) after switching.
CONCLUSIONS
Intravitreal faricimab may improve anatomic outcomes in patients with previously treated nAMD, while maintaining VA in the short-term.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
目的
评估先前接受抗血管内皮生长因子（VEGF）治疗的新生血管性年龄相关性黄斑变性（nAMD）患者对玻璃体腔内 faricimab 治疗的解剖和功能结局。
设计
回顾性、干预性、连续病例系列。
受试者
纳入了接受≥4 次连续 faricimab 治疗的既往治疗过的 nAMD 患者。研究期间为 2022 年 3 月至 11 月。
方法
从电子病历中提取临床和影像学数据。获取中心凹视网膜厚度（CFT）、最大纤维血管色素上皮脱离（fvPED）高度和 Snellen 视力（VA）。采用广义估计方程分析 CFT、最大 fvPED 高度和最小角分辨率 VA 的对数变化。
主要观察指标
在接受 faricimab 治疗之前和之后≥4 次 faricimab 玻璃体腔内注射后的 CFT、最大 fvPED 高度和 Snellen VA 的变化。
结果
在研究期间，符合纳入标准的 191 名患者的 218 只眼。平均年龄为 79.9（范围，70.6-89.2）岁。在接受 faricimab 治疗之前，平均接受了 34.2 次（范围，6.4-62）抗 VEGF 玻璃体腔内注射。在接受≥4 次 faricimab 注射后，发现以下结果。转换为 faricimab 前的最小角分辨率 VA 的对数平均值为 0.58（Snellen VA∼20/76；范围，20/22-20/264），转换后为 0.55（Snellen VA∼20/71；范围，20/21-20/235；P=0.20）。转换为 faricimab 前最大 fvPED 高度的平均值为 195.0μm（范围，50.2-339.8μm），转换后改善至 165.0μm（范围，33.6-296.4μm；P<0.001）。转换为 faricimab 前 CFT 的平均值为 354.8μm（范围，184.7-524.9μm），转换后改善至 306.6μm（范围，144.4-468.8μm；P<0.001）。转换前有 36.7%（218 只眼中的 80 只）的眼内存在视网膜内液，转换后减少至 24.8%（218 只眼中的 54 只，P<0.001）。转换前有 53.2%（218 只眼中的 116 只）的眼存在视网膜下液，转换后减少至 26.6%（218 只眼中的 58 只，P<0.001）。
结论
玻璃体腔内 faricimab 治疗可能改善既往治疗的 nAMD 患者的解剖学结局，同时在短期内保持 VA。
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