关键词: ABCC6 Aflibercept Angioid streaks Anti-VEGF Choroidal neovascularization Pseudoxanthoma elasticum

Mesh : Adult Choroid / pathology Choroidal Neovascularization / diagnosis drug therapy etiology Female Fluorescein Angiography Follow-Up Studies Fundus Oculi Humans Intravitreal Injections Male Middle Aged Prospective Studies Pseudoxanthoma Elasticum / complications diagnosis Quality of Life Receptors, Vascular Endothelial Growth Factor / administration & dosage antagonists & inhibitors Recombinant Fusion Proteins / administration & dosage Tomography, Optical Coherence Treatment Outcome Visual Acuity Young Adult

来  源:   DOI:10.1007/s00417-019-04551-4   PDF(Sci-hub)

Abstract:
OBJECTIVE: To evaluate the use of 2 mg intravitreal aflibercept for treatment of choroidal neovascularization (CNV) secondary to angioid streaks in patients with pseudoxanthoma elasticum (PXE).
METHODS: In this 12-month prospective, open-label, uncontrolled, non-randomized interventional clinical trial, 15 PXE patients with CNV (mean age: 53 years, range 22-65) received one initial intravitreal injection of 2 mg aflibercept. Further injections were based on CNV activity at monthly examinations. The primary endpoint was change of best corrected visual acuity (BCVA) after 12 months. Secondary outcomes were change of central retinal thickness (CRT), leakage from CNV, retinal sensitivity, and vision-related quality of life.
RESULTS: BCVA improved from 75.0 ± 10.8 (± SD, Snellen equivalent 20/32) to 79.3 ± 7.3 ETDRS letters (20/32) at final visit (p = 0.083). CRT decreased from 317 ± 81 to 279 ± 51 μm (p = 0.004). Retinal sensitivity on microperimetry changed from 17.8 ± 4.5 to 18.5 ± 4.3 dB (p = 0.103) and vision-related quality of life from a VQF-25 score of 80.7 ± 10.4 to 83.5 ± 14.5 (p = 0.554). The mean number of injections was 6.7 ± 2.6, and 5 participants had persistent or reactivated CNV activity at final visit. The observed adverse events were comparable with studies on aflibercept for other indications.
CONCLUSIONS: The results of this study indicate that intravitreal aflibercept is a treatment option for CNV secondary to PXE.
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