Braimah, I.Z., Agarwal, K., Mansour, A., Chhablani, J.
期刊名称：The British journal of ophthalmology
阿柏 体腔 西普
摘要：目的：旨在评估玻璃体腔注射ziv-阿柏西普（IVZ）治疗对贝伐单抗和雷珠单抗无反应的新生血管性年龄相关性黄斑变性（nAMD）患者的疗效。方法：进行了一项回顾性分析，对16只眼（14名患者）接受了贝伐单抗和雷珠单抗预先治疗nAMD，并根据需要进行IVZ（1.25mg / 0.05mL）治疗12个月的患者进行了研究。主要终点指标是最佳矫正视力（BCVA）平均变化，次要终点指标包括中央黄斑厚度（CMT），视网膜色素上皮脱离（RPED）高度的平均变化，最长治疗间隔时间，视网膜下液（ SRF）和视网膜内液（IRF）及不良事件。结果：基线和IVZ治疗后最小分辨角度（logMAR）BCVA平均对数（p = 0.978）无变化。 12个月内IVZ平均注射次数为5.9±3.3次，转为IVZ前的平均注射血管内皮生长因子（VEGF）次数为8.4±4.7次。 IVZ治疗期间的平均治疗间隔较长（114.4±67.1天），而IVZ治疗前为76.3±54.6天（p = 0.03）。 5只（31.25％）眼的视力增加至少0.1 logMAR，3只眼（18.75％）具有稳定的BCVA（0.1 logMAR），8只眼（50％）BCVA下降至少0.1 logMAR。与基线相比，12个月时平均CMT，RPED高度和IRF和SRF的存在没有显着差异。结论：IVZ提高了无反应者的治疗间隔时间，但视力和解剖预后无明显变化。
AIM:To evaluate 12-month outcome of intravitreal ziv-aflibercept (IVZ) therapy in eyes with neovascular age-related macular degeneration (nAMD) that are non-responsive to bevacizumab and ranibizumab.METHODS:This retrospective study included 16 eyes (14 patients) with nAMD who were on prior treatment with bevacizumab and ranibizumab and were treated with as-needed IVZ (1.25 mg/0.05 mL) for 12 months. The primary outcome measure was the mean change in best corrected visual acuity (BCVA) and secondary outcome measures included mean change in central macular thickness (CMT), retinal pigment epithelial detachment (RPED) heights, longest treatment free interval, presence of subretinal fluid (SRF) and intraretinal fluid (IRF) and adverse events.RESULTS:There was no change in the mean logarithm of minimum angle of resolution (logMAR) BCVA at baseline and following treatment with IVZ therapy (p=0.978). The mean number of IVZ injections during 12 months was 5.9±3.3, and the mean number of antivascular endothelial growth factors (VEGFs) injections prior to switching to IVZ was 8.4±4.7. The mean treatment free interval was longer during IVZ therapy (114.4±67.1 days) compared with 76.3±54.6 days before IVZ therapy (p=0.03). Five (31.25%) eyes had visual gains of at least 0.1 logMAR, 3 (18.75%) eyes had stable BCVA (within 0.1 logMAR) and 8 (50%) eyes had BCVA decline of at least 0.1 logMAR. There was no significant difference in the mean CMT, RPED heights and presence of IRF and SRF at 12 months compared with baseline. No adverse events were noted.CONCLUSION:IVZ increased the treatment free interval in non-responders but no significant change in visual and anatomic outcomes.