玻璃体内法尼单抗治疗难治性新生血管性老年性黄斑变性的短期疗效

Wissam Aljundi, Cristian Munteanu, Berthold Seitz, Alaa Din Abdin
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摘要

目的评估在真实世界环境中使用玻璃体内法尼单抗(IVF)治疗既往接受过治疗的难治性新生血管性年龄相关性黄斑变性(nAMD)的短期疗效。方法回顾性单中心研究包括 44 只眼睛,这些眼睛接受了法尼单抗 6 mg/0.05 mL 的 4 × 每月一次玻璃体内注射 (IVI) 治疗,并在最后一次 IVI(16 W)后随访 4 周。患者在接受至少三种其他抗血管内皮生长因子(anti-VEGF)治疗后转为IVF治疗。主要结果指标包括最佳矫正视力(BCVA)、黄斑中心厚度(CMT)、眼底脉络膜厚度(SFCT)和视网膜积液分布。平均年龄为 79 ± 7 岁。在转用IVF之前,曾接受抗VEGF治疗的总次数为32±15次/眼。16W时,BCVA(logMAR)从0.65±0.26显著改善到0.50±0.23(p < 0.01)。16 瓦时,CMT(微米)从 422 ± 68 显著降至 362 ± 47(p < 0.01)。SFCT 在 16 W 时没有明显变化(p = 0.06)。有视网膜下积液(SRF)的眼睛数量在 16 W 时从 29(65%)显著下降到 13(29%)(p = 0.001)。视网膜内积液或色素上皮脱落的分布没有明显变化(p > 0.05)。8只眼睛(18%)的积液得到了完全清除。结论 在短期内,IVF 可使 CMT 明显减少,BCVA 明显改善,因此似乎是以前治疗过的难治性 nAMD 的有效治疗方案,且无相关不良反应。
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Short-term outcomes of intravitreal faricimab for refractory neovascular age-related macular degeneration

Purpose

To assess the short-term outcomes of intravitreal faricimab (IVF) for previously treated refractory neovascular age-related macular degeneration (nAMD) in a real-world setting.

Methods

A retrospective monocentric study including 44 eyes treated with an upload of 4 × monthly intravitreal injections (IVI) of faricimab 6 mg/0.05 mL and followed for 4 weeks after last IVI (16 W). Patients were switched to IVF after treatment with at least three other anti-vascular endothelial growth factors (anti-VEGF). Main outcome measures included best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and retinal fluid distribution.

Results

44 eyes of 44 patients with previously treated refractory nAMD (63% males) were included. Mean age was 79 ± 7 years. The total number of previous anti-VEGF before switching to IVF was 32 ± 15 IVIs/eye. BCVA (logMAR) improved significantly from 0.65 ± 0.26 to 0.50 ± 0.23 at 16 W (p < 0.01). CMT (µm) decreased significantly from 422 ± 68 to 362 ± 47 at 16 W (p < 0.01). SFCT did not change significantly at 16 W (p = 0.06). The number of eyes with subretinal fluid (SRF) decreased significantly from 29 (65%) to 13 (29%) at 16 W (p =0.001). There were no significant changes regarding the distribution of intraretinal fluid or pigment epithelial detachment (p > 0.05). A complete fluid resolution was achieved in 8 eyes (18%). No adverse events were noticed.

Conclusion

In the short term, IVF led to a significant decrease in CMT as well as a significant improvement of BCVA and thus appears to be an effective treatment option for previously treated refractory nAMD without relevant adverse effects.

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