Comparison of two different treatment regimens' efficacy in neovascular age-related macular degeneration in Turkish population—based on real life data-Bosphorus RWE Study Group

• 作者: ?hsan Y?lmaz ?rfan Perente ?smail Umut Onur ?zen Ayranc?Osmanba?o?lu ?zgür Artunay Abdullah?zkaya Ali Demircan Burak Erden Cengiz Alag?z Dilek Ya?a Erdem Eri? G?khan Demir Gürkan Erdo?an Havva Kald?r?m Kübra Sar?c? Levent Karaba? Mehmet Demir Mehmet Erdo?an Mine?ztürk Nihat Say?n Sad?k Etka Bayramo?lu Selim B?lükba?? Sezin?zdo?an Erkul Zeynep Alk?n Zeynep Y?lmazabdurrahmano?lu
• 来源期刊: 国际眼科杂志:英文版
• 学科: 工学
• 关键词: AFLIBERCEPT NEOVASCULAR AGE-RELATED MACULAR degeneration RANIBIZUMAB loading dose treatment REGIMEN
• 年，卷（期）: 2020,（1）
• 页码范围: 104-111
• 页数: 8页
• 分类号: TP3

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