Kim Yung-Hwi, Moon Tae Kyu, Ji Yong-Sok
Department of Ophthalmology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
MSC Research Institute, Parangsae Eye Clinic, Gwangju, Republic of Korea.
Ophthalmol Ther. 2024 Oct;13(10):2679-2695. doi: 10.1007/s40123-024-01010-0. Epub 2024 Aug 12.
The purpose of this study is to identify the factors affecting neovascular age-related macular degeneration (nAMD) disease stability after brolucizumab treatment.
We retrospectively analyzed the medical records of 31 patients (31 eyes) with recalcitrant nAMD who were switched to brolucizumab after conventional anti-vascular endothelial growth factor (VEGF) treatment. We divided patients into two groups by treatment extension (TE) period: group 1 with TE < 12 weeks (N = 16) and group 2 with TE ≥ 12 weeks (N = 15). We compared outcomes between the groups at 2, 4, 8, and 12 weeks, including morphological characteristics of choroidal neovascularization (CNV). Logistic regression analysis identified factors associated with TE ≥ 12 weeks.
Group 2 had a significantly greater proportion of patients with dry macula (subretinal and intraretinal fluids absent) than group 1 (60 vs. 12.5%) at 2 weeks (P < 0.05). Best-corrected visual acuity (BCVA) and subfoveal choroidal thickness (SFCT) did not differ significantly between groups at all timepoints. Central subfield retinal thickness (CST) was significantly lower in group 2 at 2 (237.1 vs. 280.8 μm; P < 0.05), 4 (224.0 vs. 262.9 μm; P < 0.05), and 8 weeks (216.8 vs. 331.1 μm; P < 0.05). Group 2 had less vessel area (0.63 vs. 1.27 mm; P < 0.05) and total vessel length (0.22 vs. 0.42 mm; P < 0.05). Choriocapillaris flow deficit (CCFd) was significantly lower in group 2 (42.7 vs. 48.2%; P < 0.05). Dry macula at 2 weeks (odds ratio [OR] = 8.3; P < 0.05) and a lower CCFd (OR = 0.73; P < 0.05) were associated with TE ≥ 12 weeks.
Early fluid-free status after switching to brolucizumab and choriocapillary function around CNV were prognostic factors for disease stability in nAMD refractory to anti-VEGF treatment.
本研究的目的是确定影响布罗珠单抗治疗后新生血管性年龄相关性黄斑变性（nAMD）疾病稳定性的因素。
我们回顾性分析了31例（31只眼）顽固性nAMD患者的病历，这些患者在接受传统抗血管内皮生长因子（VEGF）治疗后改用布罗珠单抗。我们根据治疗延长（TE）期将患者分为两组：第1组TE＜12周（N = 16），第2组TE≥12周（N = 15）。我们比较了两组在2、4、8和12周时的结果，包括脉络膜新生血管（CNV）的形态特征。逻辑回归分析确定了与TE≥12周相关的因素。
在2周时，第2组干性黄斑（无视网膜下和视网膜内液）患者的比例显著高于第1组（60%对12.5%）（P＜0.05）。在所有时间点，两组之间的最佳矫正视力（BCVA）和黄斑中心下脉络膜厚度（SFCT）无显著差异。第2组在2周（237.1对280.8μm；P＜0.05）、4周（224.0对262.9μm；P＜0.05）和8周（216.8对331.1μm；P＜0.05）时的中心子野视网膜厚度（CST）显著更低。第2组的血管面积（0.63对1.27mm；P＜0.05）和总血管长度（0.22对0.42mm；P＜0.05）更小。第2组的脉络膜毛细血管血流不足（CCFd）显著更低（4
