Effect of aflibercept in patients with age-related macular degeneration.
Effect of aflibercept in patients with age-related macular degeneration.
复制标题
阿柏西普对年龄相关性黄斑变性患者的影响。
DOI：
10.1007/s10792-015-0089-z
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发表时间：
2016
期刊：
影响因子：
1.6
通讯作者：
Matsubara M.
中科院分区：
文献类型：
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作者：
Okuma,H;Mimura T;Goto M;Kamei Y;Yoshida M;Kondo A;Matsubara M.
本研究的目的是评估玻璃体内注射阿柏西普 (IVA) 标准诱导治疗在完成诱导治疗 6 个月后对渗出性年龄相关性黄斑变性 (AMD) 患者的疗效。 11 只患有典型 AMD (tAMD) 的眼睛和 13 只患有息肉样脉络膜血管病变 (PCV) 的眼睛每月接受三个月剂量的 IVA（第 0、4 和 8 周为 2 mg/0.05 ml），以治疗渗出性 AMD。测量最佳矫正视力 (BCVA)，并在基线和每次每月访视时进行光学相干断层扫描，直至 IVA 后 6 个月。治疗失败被定义为持续性或复发性AMD，表现为黄斑囊样水肿、浆液性视网膜脱离和色素上皮脱离。 IVA 后 6 个月时，平均 logMAR BCVA 从基线时的 0.62 ± 0.46 改善至 0.54 ± 0.43 (p < 0.05)。 IVA 后 3 个月的成功率为 95.8%，6 个月的成功率为 75.0%。通过单变量分析，IVA 失败与治疗前没有 PVD (r=0.35) 以及 AMD 类型 (tAMD,r=0.43) 呈正相关。 Cox 比例风险分析表明，治疗前缺乏 PVD 与 IVA 失败风险增加相关（OR = 33.17，p = 0.0219）。三个月的诱导 IVA 在长达 6 个月的 AMD 患者监测中取得了很高的成功率。与 IVA 失败相关的因素是缺乏 PVD 和存在 tAMD。因此，诱导治疗后继续 IVA 可能有利于治疗 tAMD 或无 PVD 患者的 AMD。
The purpose of this study was to evaluate the efficacy of standard induction therapy with intravitreal aflibercept (IVA) in patients with exudative age-related macular degeneration (AMD) at 6 months after completion of induction therapy. Eleven eyes with typical AMD (tAMD) and 13 eyes with polypoidal choroidal vasculopathy (PCV) received three monthly doses of IVA (2 mg/0.05 ml in weeks 0, 4, and 8) for treatment of exudative AMD. Best-corrected visual acuity (BCVA) was measured, and optical coherence tomography was performed at baseline and at each monthly visit until 6 months after IVA. Treatment failure was defined as persistent or recurrent AMD that presented with cystoid macular edema, serous retinal detachment, and pigment epithelium detachment. Mean logMAR BCVA was improved from 0.62 ± 0.46 at baseline to 0.54 ± 0.43 at 6 months after IVA (p< 0.05). The success rate was 95.8 % at 3 months and 75.0 % at 6 months after IVA. Failure of IVA was positively associated with the absence of PVD before treatment (r= 0.35) and with the AMD type (tAMD,r= 0.43) by univariate analysis. Cox proportional hazards analysis demonstrated that the absence of PVD before treatment was associated with an increased risk of failure of IVA (OR = 33.17,p= 0.0219). Three months of induction IVA achieved a high success rate in patients with AMD monitored for up to 6 months. Factors associated with failure of IVA were the absence of PVD and the presence of tAMD. Accordingly, continuation of IVA following induction therapy may be beneficial to manage AMD in patients with tAMD or those without PVD.