Hara Chikako, Fujimoto Satoko, Fukushima Yoko, Sayanagi Kaori, Nishida Kentaro, Maruyama Kazuichi, Sato Shigeru, Maeno Takatoshi, Nishida Kohji
Department of Ophthalmology, Graduate School of Medicine, University of Osaka, Osaka 565-0871, Japan.
Department of Vision Informatics Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, University of Osaka, Suita 565-0871, Japan.
J Clin Med. 2025 Jul 8;14(14):4824. doi: 10.3390/jcm14144824.
: This study aimed to assess the initial anatomical and functional outcomes of switching to aflibercept 8 mg in patients with neovascular age-related macular degeneration (nAMD) previously treated with anti-vascular endothelial growth factor (VEGF) therapy. : Patients with nAMD previously treated with anti-VEGF drugs were switched to aflibercept 8 mg. Patients with any exudative changes (subretinal fluid [SRF], intraretinal fluid [IRF] or serous pigment epithelial detachment [sPED]) at the time of the first aflibercept 8 mg injection and whose dosing interval before and after switching did not differ by more than ±7 days were included. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), and the presence of SRF, IRF, and sPED were evaluated before and after switching to aflibercept 8 mg. A total of 102 eyes from 98 patients were included in the analysis. The drugs used prior to switching were faricimab in five eyes, brolucizumab in six eyes, and aflibercept 2 mg in 91 eyes, with a mean interval of 63.7 ± 20.0 days from the last pre-switch injection and 64.9 ± 20.1 days to the first post-switch visit. The CFT was significantly reduced from 272 ± 85 µm to 246 ± 79 µm ( < 0.0001). The BCVA remained unchanged at 0.27 ± 0.35 logMAR. During switching, SRF, IRF, and sPED were observed in 70, 24, and 38 eyes, respectively. At the post-switch visit, complete resolution of exudative changes was observed in 44% of eyes with SRF, 55% with IRF, and 29% with sPED. No ocular or systemic adverse effects were observed. : As an initial response to switching to aflibercept 8 mg in a real-world setting, SRF and IRF completely resolved in approximately half of the patients, and sPED resolved in about 30% of cases.
本研究旨在评估在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）患者中转换为8毫克阿柏西普后的初始解剖学和功能结局。
先前接受抗VEGF药物治疗的nAMD患者转换为8毫克阿柏西普。纳入首次注射8毫克阿柏西普时出现任何渗出性改变（视网膜下液[SRF]、视网膜内液[IRF]或浆液性色素上皮脱离[sPED]）且转换前后给药间隔相差不超过±7天的患者。在转换为8毫克阿柏西普前后评估最佳矫正视力（BCVA）、中心凹厚度（CFT）以及SRF、IRF和sPED的存在情况。分析共纳入98例患者的102只眼。转换前使用的药物中，5只眼使用了法西单抗，6只眼使用了布罗利尤单抗，91只眼使用了2毫克阿柏西普，从最后一次转换前注射到首次转换后就诊的平均间隔为63.7±20.0天，到首次转换后就诊的平均间隔为64.9±20.1天。CFT从272±85微米显著降至246±79微米（<0.0001）。BCVA保持不变，为0.27±0.35 logMAR。转换期间，分别在70只、24只和38只眼中观察到SRF、IRF和sPED。在转换后就诊时，44%有SRF的眼、55%有IRF的眼和29%有sPED的眼观察到渗出性改变完全消退。未观察到眼部或全身不良反应。
作为在现实环境中转换为8毫克阿柏西普的初始反应，约一半患者的SRF和IRF完全消退，约30%的病例中sPED消退。
