阿柏西普治疗雷珠单抗效果不佳的CNV伴难治性色素上皮脱离的疗效（英文）

Early shift from ranibizumab to aflibercept for resistant pigment epitelial detachment in classical choroidal neovascularization

目的:评估雷珠单抗反应欠佳患者治疗早期转为阿柏西普治疗疗效。方法:该研究包括38例湿性年龄相关性黄斑变性(W-AMD)患者。18例反应欠佳患者改用玻璃体内阿柏西普(IVA)每月3次疗法,其余20例反应欠佳患者持续进行玻璃体内雷珠单抗(IVR)治疗,每月增加3次使用。所有改变均行荧光素血管造影术(FA)和光学相干断层扫描成像术(OCT)评估。结果:患者术前平均视力(VA)和黄斑中心厚度(CMT)分别为0.84±0.47 logM AR和360±84μm。经过6次IVR或3次IVR联合3次IVA治疗1mo后,两组患者视力分别为1.1±0.14(P=0.11)logM AR和0.48±0.37(P=0.019)logM AR,黄斑中心厚度分别为300±79μm(P=0.002)和271±51μm(P=0.002)。结论:对于雷珠单抗治疗反应欠佳患者,减少重复性治疗早期转为使用阿柏西普疗法对于视力康复是更好的选择。

AIM： To evaluate the therapeutic effect of aflibercept in patients with suboptimal response to ranibizumab therapy in the early period.METHOD： Thirty-eight patients with wet type age related macular degeneration（W-AMD）were involved in this study. Eighteen patients with suboptimal response were shifted to 3 doses monthly intravitreal aflibercept therapy（IVA）and left 20 patients with suboptimal response went on 3 more monthly intravitreal ranibizumab（IVR）. All changes were evaluated with fluorescein anigography（FA）and optical coherence tomography（OCT）.RESULTS： Preoperative mean visual acuity（VA）and central macular thickness（CMT）of patients were 0.84±0.47 logMAR and 360±84 μm, respectively. One month after last IVR and IVA treatments, VA of patients were 1.1±0.34（P=0.11）logMAR and 0.48±0.37（P=0.019）logMAR and CMTs were 300±79 μm（P=0.002）and 271±51 μm（P=0.002）, respectively. CONCLUSION： To eliminate repeated therapy for patients with suboptimal response to ranibizumab therapy, aflibercept might be a good alternative for early visual rehabilitation.