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玻璃体内法米替尼治疗难治性新生血管性年龄相关性黄斑变性的短期疗效。

Short-term outcomes of intravitreal faricimab for refractory neovascular age-related macular degeneration.

机构信息

Department of Ophthalmology, Saarland University Medical Center UKS, Kirrberger Street 100, Building 22, 66421, Homburg/Saar, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2024 Sep;262(9):2867-2874. doi: 10.1007/s00417-024-06485-y. Epub 2024 Apr 12.

Abstract

PURPOSE

To assess the short-term outcomes of intravitreal faricimab (IVF) for previously treated refractory neovascular age-related macular degeneration (nAMD) in a real-world setting.

METHODS

A retrospective monocentric study including 44 eyes treated with an upload of 4 × monthly intravitreal injections (IVI) of faricimab 6 mg/0.05 mL and followed for 4 weeks after last IVI (16 W). Patients were switched to IVF after treatment with at least three other anti-vascular endothelial growth factors (anti-VEGF). Main outcome measures included best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and retinal fluid distribution.

RESULTS

44 eyes of 44 patients with previously treated refractory nAMD (63% males) were included. Mean age was 79 ± 7 years. The total number of previous anti-VEGF before switching to IVF was 32 ± 15 IVIs/eye. BCVA (logMAR) improved significantly from 0.65 ± 0.26 to 0.50 ± 0.23 at 16 W (p < 0.01). CMT (µm) decreased significantly from 422 ± 68 to 362 ± 47 at 16 W (p < 0.01). SFCT did not change significantly at 16 W (p = 0.06). The number of eyes with subretinal fluid (SRF) decreased significantly from 29 (65%) to 13 (29%) at 16 W (p = 0.001). There were no significant changes regarding the distribution of intraretinal fluid or pigment epithelial detachment (p > 0.05). A complete fluid resolution was achieved in 8 eyes (18%). No adverse events were noticed.

CONCLUSION

In the short term, IVF led to a significant decrease in CMT as well as a significant improvement of BCVA and thus appears to be an effective treatment option for previously treated refractory nAMD without relevant adverse effects.

摘要

目的

评估玻璃体内 faricimab(IVF)治疗既往治疗的难治性新生血管性年龄相关性黄斑变性(nAMD)的短期疗效。

方法

这是一项回顾性单中心研究,纳入了 44 只眼,这些眼接受了 4 次每月的玻璃体内注射(IVI)faricimab(6mg/0.05ml)加载治疗,在最后一次 IVI 后随访 4 周(16 周)。在接受至少 3 种其他抗血管内皮生长因子(anti-VEGF)治疗后,患者被转换为 IVF。主要观察指标包括最佳矫正视力(BCVA)、中心黄斑厚度(CMT)、中心凹下脉络膜厚度(SFCT)和视网膜液分布。

结果

共纳入了 44 例(63%为男性)既往治疗的难治性 nAMD 患者的 44 只眼。平均年龄为 79±7 岁。在转换为 IVF 之前,抗 VEGF 治疗的总次数为 32±15 次/眼。在 16 周时,BCVA(logMAR)从 0.65±0.26 显著改善至 0.50±0.23(p<0.01)。CMT(µm)从 422±68 显著减少至 362±47(p<0.01)。在 16 周时,SFCT 无显著变化(p=0.06)。有视网膜下液(SRF)的眼数从 29 只(65%)显著减少至 13 只(29%)(p=0.001)。视网膜内液或色素上皮脱离的分布无显著变化(p>0.05)。8 只眼(18%)达到完全液体积聚缓解。无不良反应发生。

结论

短期内,IVF 可显著降低 CMT,显著提高 BCVA,因此对既往治疗的难治性 nAMD 是一种有效的治疗选择,且无明显不良反应。

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