Long-term outcomes of intravitreal activated protein C injection for ischemic central retinal vein occlusion: an extension trial.
Long-term outcomes of intravitreal activated protein C injection for ischemic central retinal vein occlusion: an extension trial.
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DOI：
10.1007/s00417-021-05072-9
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Nishida K
中科院分区：
文献类型：
--
作者：
Hara C;Kamei M;Sakaguchi H;Matsumura N;Sakimoto S;Suzuki M;Nishida K;Fukushima Y;Nishida K
我们之前一项为期一年的初步研究评估了玻璃体内注射激活蛋白C(APC)对10只缺血性视网膜中央静脉阻塞(CRVO)的疗效。注射APC后1年，5只眼(50%)视网膜无灌注区(RNP)再灌注率超过基线的50%。本研究评估了玻璃体内植入APC的远期疗效和安全性。先导研究中的10只眼包括在这项研究中。在试点研究结束后，医生可以自行决定是否进行其他治疗。我们评估了视力(VA)、视网膜中央厚度(CRT)和血流状态，以及长期的不良事件和严重程度。中位随访期为60个月(48~68个月)。与治疗前相比，治疗后视力明显改善(P <； 0.001)，最小分辨角度的对数从1.39提高到1.06。显像管显着改善(P <； 0.001)，从1090升至195μm。RNP面积从基线时的平均29.7DAs降至上次检查时的平均16.5DAs(首次APC治疗后6个月平均为40 ± 6.5DAs)。未发现与玻璃体内APC相关的不良事件。玻璃体内APC无并发症，临床病程改善，改善的RNP长期维持，提示玻璃体内APC可能是CRVO的一种替代治疗方法。
Our previous 1-year pilot study evaluated the efficacy of intravitreally injected activated protein C (APC) in 10 eyes with ischemic central retinal vein occlusion (CRVO). The reperfusion of the areas of retinal nonperfusion (RNP) exceeded 50% of the baseline in five (50%) eyes 1 year after the APC injection. The current study evaluated the long-term efficacy and safety of intravitreal APC. The 10 eyes in the pilot study were included in this study. Other treatments were administered at the physicians’ discretion after the pilot study. We evaluated visual acuity (VA), central retinal thickness (CRT) and perfusion status, and adverse events and severity over the long term. The median follow-up was 60 months (range, 48–68 months). Compared with baseline, the post-treatment VA improved significantly (P < 0.001) from 1.39 to 1.06 logarithm of the minimum angle of resolution. The CRT improved significantly (P < 0.001) from 1090 to 195 μm at the last visit. The RNP areas decreased from an average 29.7 disc areas (DAs) at baseline to an average 16.5 DAs at the last examination (mean, 40 ± 6.5 months after the first APC treatment). No adverse events were related to intravitreal APC. No complications were associated with intravitreal APC, the clinical course improved, and improved RNP was maintained for the long term, suggesting that intravitreal APC may be an alternative treatment for CRVO.
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