Department of Ophthalmology, Fuchu Hospital, Izumi 594-0076, Osaka, Japan.
Department of Ophthalmology, PL Hospital, Tondabashi 584-8585, Osaka, Japan.
Medicina (Kaunas). 2024 Jul 19;60(7):1170. doi: 10.3390/medicina60071170.
: In this study, our objective was to assess and compare the changes in visual and structural outcomes among patients with neovascular age-related macular degeneration (nAMD) who were switched from intravitreal aflibercept (IVA) to either intravitreal brolucizumab (IVBr) or intravitreal faricimab (IVF) injections in a clinical setting. : This observational clinical study included 20 eyes of 20 patients switched to brolucizumab and 15 eyes of 14 patients switched to faricimab from aflibercept in eyes with nAMD. We measured the structural outcome (central macular thickness (CMT)) and the visual outcome (best-corrected visual acuity (BCVA); logMAR) as follows: just before the most recent IVA injection (B0), one month after the most recent IVA injection (B1), just before the first IVBr or IVF injection (A0), one month after (A1) and three months after (A3) the first IVBr or IVF injection. : BCVA showed significant improvement at A1 (0.25 ± 0.34) and at A3 (0.19 ± 0.24) compared to A0 (0.38 ± 0.35) in the IVBr group ( = 0.0156, = 0.0166, respectively). CMT (μm) was significantly thinner at A1 (IVBr: 240.55 ± 51.82, IVF: 234.91 ± 47.29) and at A3 (IVBr: 243.21 ± 76.15, IVF: 250.50 ± 72.61) compared to at A0 (IVBr: 303.55 ± 79.18, IVF: 270.33 ± 77.62) in the IVBr group (A1: = 0.0093, A3: = 0.0026) and in the IVF group (A1: = 0.0161, A3: = 0.0093). There was no significant difference in BCVA and CMT improvement observed between two groups at any time point ( > 0.05 for all). : Switching from aflibercept to either brolucizumab or faricimab has a significant anatomical effect in eyes with nAMD and both treatments appear to be effective short-term treatment options. There is a trend towards greater visual improvements and reductions in CMT with brolucizumab.
在这项研究中,我们的目的是评估和比较在临床环境中,将接受玻璃体内阿柏西普(IVA)治疗的新生血管性年龄相关性黄斑变性(nAMD)患者转换为玻璃体内布罗利珠单抗(IVBr)或玻璃体内 faricimab(IVF)注射后的视觉和结构结果变化。这项观察性临床研究纳入了 20 名患者的 20 只眼和 14 名患者的 15 只眼,这些患者的 nAMD 眼从阿柏西普转换为布罗利珠单抗或 faricimab。我们测量了结构结果(中央黄斑厚度(CMT))和视觉结果(最佳矫正视力(BCVA);logMAR)如下:在最近一次 IVA 注射前(B0),在最近一次 IVA 注射后 1 个月(B1),在第一次 IVBr 或 IVF 注射前(A0),在第一次 IVBr 或 IVF 注射后 1 个月(A1)和 3 个月(A3)。BCVA 在 A1 时(0.25 ± 0.34)和 A3 时(0.19 ± 0.24)明显优于 A0 时(0.38 ± 0.35)( = 0.0156, = 0.0166)。IVBr 组中,CMT(μm)在 A1 时(IVBr:240.55 ± 51.82,IVF:234.91 ± 47.29)和 A3 时(IVBr:243.21 ± 76.15,IVF:250.50 ± 72.61)明显更薄,而 A0 时(IVBr:303.55 ± 79.18,IVF:270.33 ± 77.62)(A1: = 0.0093,A3: = 0.0026),在 IVF 组中(A1: = 0.0161,A3: = 0.0093)。在任何时间点,两组之间在 BCVA 和 CMT 改善方面均无显著差异(均>0.05)。从阿柏西普转换为布罗利珠单抗或 faricimab 对 nAMD 眼具有显著的解剖学效果,两种治疗方法似乎都是有效的短期治疗选择。布罗利珠单抗的视力改善和 CMT 降低趋势更大。