玻璃体内Pegcetacoplan治疗老年性黄斑变性地理性萎缩的临床经验。

IF 4.2 1区 医学 Q1 OPHTHALMOLOGY
Mengxi Shen , Alessandro Berni , Jeremy Liu , Farhan Hiya , Gissel Herrera , Omar S. El-Mulki , Sara Beqiri , Yuxuan Cheng , James Kastner , Omer Trivizki , Sivathanu Kumar , Yi Zhang , Viet Hoan Le , Robert C. O'Brien , Maura Di Nicola , Zohar Yehoshua , Sander R. Dubovy , Ruikang K. Wang , Giovanni Gregori , Philip J. Rosenfeld
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引用次数: 0

摘要

目的报道玻璃体内注射pegcetacoplan治疗年龄相关性黄斑变性(AMD)的地理性萎缩(GA)的临床经验。设计回顾性介入病例系列。方法采用15mg玻璃体内pegcetacoplan治疗伴有AMD继发GA症状的眼睛,并参与了一项正在进行的前瞻性扫描源光学相干断层扫描血管造影(SS-OCTA)成像研究。在pegcetacoplan治疗之前和期间,所有的眼睛都进行了SS-OCTA成像,以评估GA病变的大小、非渗出性黄斑新生血管(MNV)的存在以及渗出的发生。随访1年,评估GA生长速率和最佳矫正视力(BCVA)。结果从2023年4月12日至2024年11月11日,154只眼注射佩克塞科普,103只眼随访1年。在基线时,11只眼睛先前接受过抗vegf治疗,9只眼睛通过SS-OCTA诊断为treatment-naïve非渗出性MNV。每只眼平均接受10±2次注射,平均间隔1.2个月。对于随访1年且GA可测量的97只眼,pegcetacoplan治疗后GA的平方根(sqrt)增长率为0.24±0.15 mm/年。在这97只眼睛中,有63只眼睛在开始培西可平治疗前进行过年度检查。在这些眼中,pegcetacoplan前的年根方根GA生长率为0.33±0.22 mm/年,pegcetacoplan后的年根方根GA生长率为0.21±0.12 mm/年,生长率下降了37% (p<0.001)。在使用pegcetacoplan前后,中央凹和非中央凹GA的生长速率无显著差异(均p≥0.80)。平均BCVA在一年内从63±14个字母下降到59±15个字母(p=0.001),中央凹GA和非中央凹GA之间无显著差异(p=0.36)。在pegcetacoplan治疗期间出现渗出的29只眼睛中,19只(66%)在基线和SS-OCTA治疗期间没有任何可检测到的MNV证据。结论使用pegcetacoplan治疗1年后的眼睛GA生长速率比之前的年增长率降低37%。Pegcetacoplan以相似的速率减缓了中央凹和非中央凹GA的生长。大多数pegcetacoplan相关的渗出不是由于可检测到的MNV。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Real-World Experience With Intravitreal Pegcetacoplan for the Treatment of Geographic Atrophy in Age-Related Macular Degeneration

Purpose

To report on the real-world experience of using intravitreal pegcetacoplan for the treatment of geographic atrophy (GA) in age-related macular degeneration (AMD).

Design

Retrospective interventional case series.

Methods

Eyes with symptomatic GA secondary to AMD were treated with 15 mg of intravitreal pegcetacoplan and participated in an ongoing prospective swept-source optical coherence tomography angiography (SS-OCTA) imaging study. All eyes underwent SS-OCTA imaging before and during pegcetacoplan therapy to assess for GA lesion size, the presence of nonexudative macular neovascularization (MNV), and the onset of exudation. The growth rate of GA and best-corrected visual acuity (BCVA) were assessed for eyes followed for 1 year.

Results

From April 12, 2023, to November 11, 2024, 154 eyes were injected with pegcetacoplan, and 103 eyes had 1-year follow-up. At baseline, 11 eyes had been previously treated with anti-VEGF therapy, and 9 eyes were diagnosed with treatment-naïve nonexudative MNV by SS-OCTA. Each eye received an average of 10 ± 2 injections, with an average interval of 1.2 months between injections. For the 97 eyes with 1 year of follow-up and measurable GA, the square-root (sqrt) GA growth rate after pegcetacoplan treatment was 0.24 ± 0.15 mm/year. Of these 97 eyes, 63 eyes had prior annual visits before pegcetacoplan treatment was started. In these eyes, the annual sqrt GA growth rate was 0.33 ± 0.22 mm/year before pegcetacoplan and 0.21 ± 0.12 mm/year after pegcetacoplan, resulting in a 37% decrease in the growth rate (P < .001). There were no significant differences in GA growth rate between foveal and nonfoveal GA, either before or after the use of pegcetacoplan (all P ≥ .80). The mean BCVA declined from 63 ± 14 to 59 ± 15 letters over 1 year (P = .001), with no significant difference between foveal and nonfoveal GA (P = .36). Among the 29 eyes developing exudation during pegcetacoplan treatment, 19 (66%) had no evidence of any detectable MNV at baseline and during treatment on SS-OCTA.

Conclusions

Eyes treated with pegcetacoplan after 1 year had a 37% reduction in GA growth rate compared with their prior annual growth rate. Pegcetacoplan slowed the growth for foveal and nonfoveal GA at a similar rate. Most of the pegcetacoplan-associated exudation was not due to detectable MNV.
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来源期刊
CiteScore
9.20
自引率
7.10%
发文量
406
审稿时长
36 days
期刊介绍: The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.
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