摘要
AIM: To compare two different anti-vascular endothelial growth factor(anti-VEGF) treatment regimens'-a priori pro re nata(PRN) and PRN regimen following^(th)e loading phaseanatomical and functional results in neovascular agerelated macular degeneration(n AMD) patients. METHODS: Totally 544 n AMD patients followed and treated with aflibercept(n=135) and ranibizumab(n=409)at 9 different centers between 2013 and 2015 were enrolled into^(th)is retrospective multicenter study. Patients with initial best corrected visual acuity(BCVA) interval of 1.3-0.3(log MAR) and a minimum follow-up of 12 mo were included. Patients under two different regimens-a priori pro re nata(1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen(3+PRN)-were compared in BCVA at 3^(th), 6^(th) and 12^(th) months, and in central macular^(th)ickness(CMT) at 6^(th) and 12^(th) months. The total study group, intravitreal ranibizumab(IVR) and intravitreal aflibercept(IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in^(th)e 1+PRN(n=101) regimen from 407 to 358 and 340 μm and in^(th)e 3+PRN(n=443) group from 398 to 318 and finally to 310 μm at months 6 and 12, respectively. Anatomically,^(th)e CMT reduction at 6^(th) month(48.5 vs 76.4;P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75;in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3^(th) month(-0.01 vs 0.12;P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6^(th)(44 vs 72) and 12^(th) month(61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3^(th) month(-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction(61 vs 89, 6^(th) month;85 vs 97, 12^(th) month) and visual gain(0.02 vs 0.16;0.02 vs 0.14;0.05 vs 0.11) was found in favor of 3+PRN group at all visits.CONCLUSION: The loading dose of anti-VEGF treatments in n AMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.
AIM: To compare two different anti-vascular endothelial growth factor（anti-VEGF） treatment regimens’-a priori pro re nata（PRN） and PRN regimen followingthe loading phaseanatomical and functional results in neovascular agerelated macular degeneration（n AMD） patients. METHODS: Totally 544 n AMD patients followed and treated with aflibercept（n=135） and ranibizumab（n=409）at 9 different centers between 2013 and 2015 were enrolled intothis retrospective multicenter study. Patients with initial best corrected visual acuity（BCVA） interval of 1.3-0.3（log MAR） and a minimum follow-up of 12 mo were included. Patients under two different regimens-a priori pro re nata（1+PRN） or 3 consecutive intravitreal injections followed by a PRN regimen（3+PRN）-were compared in BCVA at 3th, 6th and 12th months, and in central macularthickness（CMT） at 6th and 12th months. The total study group, intravitreal ranibizumab（IVR） and intravitreal aflibercept（IVA） groups were evaluated separately. RESULTS: The mean CMT decreased inthe 1+PRN（n=101） regimen from 407 to 358 and 340 μm and inthe 3+PRN（n=443） group from 398 to 318 and finally to 310 μm at months 6 and 12, respectively. Anatomically,the CMT reduction at 6th month（48.5 vs 76.4; P<0.05） was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75; in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3th month（-0.01 vs 0.12; P<0.001）. In IVR group, CMT reduction was in greater in 3+PRN at 6th（44 vs 72） and 12th month（61 vs 84）, but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3th month（-0.02 vs 0.11, P<0.05）. In IVA group, although statistically insignificant, CMT reduction(61 vs 89, 6th month; 85 vs 97, 12th month) and visual gain（0.02 vs 0.16; 0.02 vs 0.14; 0.05 vs 0.11） was found in favor of 3+PRN group at all visits.CONCLUSION: The loading dose of anti-VEGF treatments in n AMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.
