Alexandra Warter, Anna Heinke, Melina Cavichini, Carlo Miguel B Galang, Fritz Gerald P Kalaw, Dirk-Uwe Bartsch, Lingyun Cheng, William R Freeman
{"title":"对单药耐药的慢性湿性老年性黄斑变性采用同时静脉内类固醇和抗血管内皮生长因子疗法。","authors":"Alexandra Warter, Anna Heinke, Melina Cavichini, Carlo Miguel B Galang, Fritz Gerald P Kalaw, Dirk-Uwe Bartsch, Lingyun Cheng, William R Freeman","doi":"10.3928/23258160-20240705-03","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objective: </strong>The purpose of this study was to analyze the safety and efficacy of combined intravitreal anti-vascular endothelial growth factor (anti-VEGF) and steroid therapeutic agents for resistant choroidal neovascularization (CNV). A retrospective observational clinical study was performed assessing anatomic and visual changes in a consecutive cohort of patients with refractory chronic wet age-related macular degeneration resistant to high-dose aflibercept therapy.</p><p><strong>Patients and methods: </strong>Twelve eyes of 12 patients with unresponsive CNV despite aggressive monthly anti-VEGF (4-mg aflibercept [mean: 43.75 ± SD23.08]) were included. Combination consisted of simultaneous administration of anti-VEGF and corticosteroids. Study measures evaluated visual acuity, central retinal thickness (CRT), and intraocular pressure.</p><p><strong>Results: </strong>Paired tests revealed significant CRT reduction from the baseline at the 1-month (388.58 ± 89.31 versus 334.00 ± 92.88, <i>P</i> = 0.0117), 2-month (388.58 ± 89.31 versus 312.08 ± 75.61, <i>P</i> = 0.0185), and 3-month (388.53 ± 89.31 versus 304.56 ± 53.28, <i>P</i> = 0.046) visit. The Kaplan-Meier curve showed a median time of remission (no retinal fluid) of 70 days (95% CI 53, 147 days).</p><p><strong>Conclusion: </strong>Combination treatment demonstrated clear anatomic improvement in eyes with anti-VEGF-resistant CNV. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:698-704.]</b>.</p>","PeriodicalId":19679,"journal":{"name":"Ophthalmic surgery, lasers & imaging retina","volume":" ","pages":"698-704"},"PeriodicalIF":0.9000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Simultaneous Intravitreal Steroid and Anti-VEGF Therapy for Monotherapy-Resistant Chronic Wet Age-Related Macular Degeneration.\",\"authors\":\"Alexandra Warter, Anna Heinke, Melina Cavichini, Carlo Miguel B Galang, Fritz Gerald P Kalaw, Dirk-Uwe Bartsch, Lingyun Cheng, William R Freeman\",\"doi\":\"10.3928/23258160-20240705-03\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and objective: </strong>The purpose of this study was to analyze the safety and efficacy of combined intravitreal anti-vascular endothelial growth factor (anti-VEGF) and steroid therapeutic agents for resistant choroidal neovascularization (CNV). A retrospective observational clinical study was performed assessing anatomic and visual changes in a consecutive cohort of patients with refractory chronic wet age-related macular degeneration resistant to high-dose aflibercept therapy.</p><p><strong>Patients and methods: </strong>Twelve eyes of 12 patients with unresponsive CNV despite aggressive monthly anti-VEGF (4-mg aflibercept [mean: 43.75 ± SD23.08]) were included. Combination consisted of simultaneous administration of anti-VEGF and corticosteroids. Study measures evaluated visual acuity, central retinal thickness (CRT), and intraocular pressure.</p><p><strong>Results: </strong>Paired tests revealed significant CRT reduction from the baseline at the 1-month (388.58 ± 89.31 versus 334.00 ± 92.88, <i>P</i> = 0.0117), 2-month (388.58 ± 89.31 versus 312.08 ± 75.61, <i>P</i> = 0.0185), and 3-month (388.53 ± 89.31 versus 304.56 ± 53.28, <i>P</i> = 0.046) visit. The Kaplan-Meier curve showed a median time of remission (no retinal fluid) of 70 days (95% CI 53, 147 days).</p><p><strong>Conclusion: </strong>Combination treatment demonstrated clear anatomic improvement in eyes with anti-VEGF-resistant CNV. <b>[<i>Ophthalmic Surg Lasers Imaging Retina</i> 2024;55:698-704.]</b>.</p>\",\"PeriodicalId\":19679,\"journal\":{\"name\":\"Ophthalmic surgery, lasers & imaging retina\",\"volume\":\" \",\"pages\":\"698-704\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ophthalmic surgery, lasers & imaging retina\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3928/23258160-20240705-03\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic surgery, lasers & imaging retina","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/23258160-20240705-03","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/1 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Simultaneous Intravitreal Steroid and Anti-VEGF Therapy for Monotherapy-Resistant Chronic Wet Age-Related Macular Degeneration.
Background and objective: The purpose of this study was to analyze the safety and efficacy of combined intravitreal anti-vascular endothelial growth factor (anti-VEGF) and steroid therapeutic agents for resistant choroidal neovascularization (CNV). A retrospective observational clinical study was performed assessing anatomic and visual changes in a consecutive cohort of patients with refractory chronic wet age-related macular degeneration resistant to high-dose aflibercept therapy.
Patients and methods: Twelve eyes of 12 patients with unresponsive CNV despite aggressive monthly anti-VEGF (4-mg aflibercept [mean: 43.75 ± SD23.08]) were included. Combination consisted of simultaneous administration of anti-VEGF and corticosteroids. Study measures evaluated visual acuity, central retinal thickness (CRT), and intraocular pressure.
Results: Paired tests revealed significant CRT reduction from the baseline at the 1-month (388.58 ± 89.31 versus 334.00 ± 92.88, P = 0.0117), 2-month (388.58 ± 89.31 versus 312.08 ± 75.61, P = 0.0185), and 3-month (388.53 ± 89.31 versus 304.56 ± 53.28, P = 0.046) visit. The Kaplan-Meier curve showed a median time of remission (no retinal fluid) of 70 days (95% CI 53, 147 days).
Conclusion: Combination treatment demonstrated clear anatomic improvement in eyes with anti-VEGF-resistant CNV. [Ophthalmic Surg Lasers Imaging Retina 2024;55:698-704.].
期刊介绍：
OSLI Retina focuses exclusively on retinal diseases, surgery and pharmacotherapy. OSLI Retina will offer an expedited submission to publication effort of peer-reviewed clinical science and case report articles. The front of the journal offers practical clinical and practice management features and columns specific to retina specialists. In sum, readers will find important peer-reviewed retina articles and the latest findings in techniques and science, as well as informative business and practice management features in one journal.
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