Liu Jing-Yao, Liu Ju-Ping, Li Xiao-Rong
Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.
Int J Ophthalmol. 2025 Sep 18;18(9):1681-1688. doi: 10.18240/ijo.2025.09.09. eCollection 2025.
AIM: To report the 24mo outcomes of vascular endothelial growth factor (VEGF) inhibitors for myopic choroidal neovascularization (mCNV) in routine clinical practice and simultaneously evaluated the real-world safety. METHODS: The patients who received intravitreal injections of VEGF inhibitors of either ranibizumab (0.5 mg) or conbercept (0.5 mg) for mCNV were analyzed from 1 January 2017 to 1 January 2022. The primary outcome variables were mean change in best-corrected visual acuity (BCVA) and central macular thickness (CMT) changes. The secondary outcome variables included IOP changes, the period of mCNV re-treatment, and ocular adverse events. RESULTS: Totally 83 patients aged 56.40±15.36y with axial length 29.67±2.09 mm were included. In visual acuity, the mean logMAR BCVA at baseline was 0.81±0.43. After the initial improvement at 1, 3, and 6mo (<0.05), from month 12 onwards, no statistical difference compared to baseline was found. The mean CMT from 1mo onwards had a statistically significant decrease compared with baseline CMT (<0.05). The regression model showed better baseline BCVA and thicker baseline CMT, significantly associated with the final outcomes. In univariate analysis, choosing 3+ (PRN) as the initial injection treatment regimen was associated with better BCVA at 24mo [hazard ratio (HR)=-0.65, 95%CI: -1.23, -0.07, =0.048]. However, the difference was not significant in multivariate analysis (HR=-0.59, 95%CI: -1.21, 0.03, =0.089). Regarding mCNV recurrence, the mean period (=0.725) and the proportion of mCNV reactivation (=1.00) were similar between ranibizumab and conbercept. Kaplan-Meier plot also analyzed that the median time of re-injection was not significantly different among gender, drug, and initial injection treatment regimen. No systemic adverse events related to the therapy were observed. CONCLUSION: BCVA gains achieved by the end of our study maintain generally sustained at the 24-mo follow-up. The findings also indicate that ranibizumab and conbercept demonstrate comparable efficacy and safety profiles. Additionally, intravitreal anti-VEGF therapy using 1+PRN regimen, offers certain advantages in both efficacy and cost-effectiveness.
目的：报告血管内皮生长因子（VEGF）抑制剂治疗近视性脉络膜新生血管（mCNV）24个月的临床疗效，并同时评估其真实世界中的安全性。 方法：分析2017年1月1日至2022年1月1日期间接受玻璃体内注射雷珠单抗（0.5mg）或康柏西普（0.5mg）治疗mCNV的患者。主要观察指标为最佳矫正视力（BCVA）的平均变化和中心黄斑厚度（CMT）的变化。次要观察指标包括眼压变化、mCNV再次治疗的时间以及眼部不良事件。 结果：共纳入83例患者，年龄56.40±15.36岁，眼轴长度29.67±2.09mm。视力方面，基线时平均logMAR BCVA为0.81±0.43。在1、3和6个月时初始改善后（<0.05），从12个月起，与基线相比无统计学差异。从1个月起，平均CMT与基线CMT相比有统计学显著下降（<0.05）。回归模型显示，较好的基线BCVA和较厚的基线CMT与最终结果显著相关。单因素分析中，选择3+（按需给药）作为初始注射治疗方案与24个月时更好的BCVA相关[风险比（HR）=-0.65，95%CI：-1.23，-0.07，P=0.048]。然而，多因素分析中差异无统计学意义（HR=-0.59，95%CI：-1.21，0.03，P=0.089）。关于mCNV复发，雷珠单抗和康柏西普之间的平均复发时间（P=0.725）和mCNV再激活比例（P=1.00）相似。Kaplan-Meier曲线分析还显示，再次注射的中位时间在性别、药物和初始注射治疗方案之间无显著差异。未观察到与治疗相关的全身不良事件。 结论：在我们的研究结束时获得的BCVA改善在24个月随访中总体上得以维持。研究结果还表明，雷珠单抗和康柏西普显示出相当的疗效和安全性。此外，采用1+按需给药方案的玻璃体内抗VEGF治疗在疗效和成本效益方面均具有一定优势。
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