A Trinity regimen with aflibercept for treatment-naive neovascular age-related macular degeneration: 2-year outcomes
A Trinity regimen with aflibercept for treatment-naive neovascular age-related macular degeneration: 2-year outcomes
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DOI：
10.1007/s00417-020-04745-1
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发表时间：
2020-05-21
影响因子：
2.7
通讯作者：
Kimura, Kazuhiro
中科院分区：
文献类型：
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作者：
Wakuta, Makiko;Nomi, Nanami;Kimura, Kazuhiro
目的评价Trinity方案治疗初治新生血管性年龄相关性黄斑变性（nAMD）的优势。方法采用Trinity方案联合玻璃体内注射阿柏西普（IVA）治疗31例nAMD初治眼，并在24个月后进行评价。根据复发频率改变三种治疗方法，即预先治疗（PRN）、治疗和扩展（TAE）和固定方案。初始治疗后，根据复发间隔选择PRN或TAE（开始4周或8周）。随后，复发间隔变得恒定，从TAE过渡到固定方案。当复发频率变得不规则时，治疗方案改为TAE。结果首次治疗后，PRN组15眼（48.4%），TAE 8周组12眼（38.7%），TAE 4周组4眼（12.9%）。所有病例的平均logMAR均显著改善，基线时为0.53 +/- 0.40，24个月时为0.36 +/- 0.34（p < 0.01），在PRN组（0.63 +/- 0.46至0.42 +/- 0.43，p < 0.01）和TAE 8周组（0.44 +/- 0.29至0.27 +/- 0.19，p < 0.05）中。TAE 4周组的LogMAR得以维持。所有和PRN、TAE 8周和TAE 4周组的平均注射次数分别为9.7、5.3、13.1和15.8，PRN组显著更少（p < 0.01）。结论：Trinity方案提供了PRN、TAE和FIXED方案的获益，同时在早期治疗阶段最大限度地减少了注射，且无视力丧失。
Purpose To evaluate the advantages of the Trinity regimen for treatment-naive neovascular age-related macular degeneration (nAMD). Methods Thirty-one treatment-naive nAMD eyes were treated using the Trinity regimen with an intravitreal aflibercept injection (IVA) and evaluated after 24 months. Three treatment methods, pro re nata (PRN), treat and extend (TAE), and fixed regimen were changed depending on recurrence frequency. After the initial treatment, PRN or TAE (started for 4 or 8 weeks) was selected as per the recurrence interval. Subsequently, the recurrence interval became constant, transitioning from a TAE to fixed regimen. When the recurrence frequency became irregular, the treatment regimen was changed to TAE. Results After the initial treatment, 15 eyes (48.4%) were allocated to the PRN group, 12 (38.7%) to the TAE 8-week group, and 4 (12.9%) to the TAE 4-week group. Mean logMAR significantly improved in all cases, 0.53 +/- 0.40 at baseline to 0.36 +/- 0.34 at 24 months (p < 0.01), in the PRN group (0.63 +/- 0.46 to 0.42 +/- 0.43, p < 0.01), and the TAE 8-week group (0.44 +/- 0.29 to 0.27 +/- 0.19, p < 0.05). LogMAR in the TAE 4-week group was maintained. The mean number of injections for all and in the PRN, TAE 8-week, and TAE 4-week groups were 9.7, 5.3, 13.1, and 15.8, respectively, with the PRN group being significantly less (p < 0.01). Conclusion The Trinity regimen delivered the benefits of the PRN, TAE, and FIXED regimens while minimizing injections during the early treatment phase without visual loss.