Mansour Ahmad M, Lima Luiz H, Battaglia Parodi Maurizio, Casella Antonio M B, Cherfan Daniel G, Arevalo J Fernando
Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.
Department of Ophthalmology, Beirut Eye Ear Specialty Hospital, Beirut, Lebanon.
J Vitreoretin Dis. 2025 Jul 8:24741264251352890. doi: 10.1177/24741264251352890.
To describe an alternate delivery of high-dose aflibercept using previous formulations (ie, prefilled syringe, vial, or compounded). A prospective pilot study was performed to analyze the short-term safety and visual gain (expressed in logMAR), including increase in intraocular pressure (IOP), resulting from a modified regimen consisting of 0.18 mL paracentesis followed by an intravitreal injection of 0.18 mL aflibercept (prefilled syringe), 0.20 mL aflibercept (vial), or 0.22 mL ziv-aflibercept (compounded). The study comprised 32 eyes (16 naïve; 18 neovascular age-related macular degeneration; 8 retinal vein occlusion). Over a follow-up of 4.1 (± 3.2) months, a mean (± SD) of 1.7 (± 0.9) high-dose injections were administered. The baseline best spectacle-corrected vision was 1.35 ± 0.71 (Snellen VA) and improved to 0.68 ± 0.46 at 1 month ( < .001) and 0.57 ± 0.43 at the final follow-up ( < .001). An increase in IOP of 0.43 ± 4.26 mm Hg was seen 1 minute after injection ( = .58). In 2 eyes (6.3%), reflux as a tiny bleb was noted. When high-dose aflibercept is neither available nor affordable, a patient's readily accessible and cost-effective regimen of aflibercept will allow an exact delivery of high-dose aflibercept, combining minimal drug reflux, minimal immediate increase in IOP, and potential clinical efficacy in the short term.
描述使用先前剂型（即预填充注射器、小瓶或配制制剂）进行高剂量阿柏西普的另一种给药方式。进行了一项前瞻性试点研究，以分析由0.18 mL前房穿刺术，随后玻璃体内注射0.18 mL阿柏西普（预填充注射器）、0.20 mL阿柏西普（小瓶）或0.22 mL阿柏西普（配制制剂）组成的改良方案所导致的短期安全性和视力改善（以logMAR表示），包括眼压升高情况。该研究纳入32只眼（16只初治眼；18只新生血管性年龄相关性黄斑变性；8只视网膜静脉阻塞）。在4.1（±3.2）个月的随访期内，平均（±标准差）进行了1.7（±0.9）次高剂量注射。基线最佳矫正视力为1.35±0.71（Snellen视力），在1个月时改善至0.68±0.46（P<0.001），在最终随访时改善至0.57±0.43（P<0.001）。注射后1分钟眼压升高0.43±4.26 mmHg（P = 0.58）。在2只眼（6.3%）中观察到有微小水泡的反流现象。当无法获得或负担不起高剂量阿柏西普时，患者易于获取且具有成本效益的阿柏西普给药方案将实现高剂量阿柏西普的精确给药，同时药物反流最小、眼压即刻升高最小，并具有短期潜在临床疗效。
