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Abstract：
Background: The aim of this study is to report short-term outcomes after the shortening of the treatment interval to 4 weeks with a treat-and-extend (TAE) regimen (Si4w) of aflibercept in patients with refractory neovascular age-related macular degeneration (nAMD). Methods: This retrospective study included 34 patients given aflibercept with a TAE regimen of a minimum of a 4-week interval when they had a limited response to bimonthly aflibercept. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) were compared before and after Si4w. The resolution of subretinal and intraretinal fluid before and after Si4w was also examined. The risk factors associated with persistent fluid were analyzed. Results: The average treatment duration until initiation of Si4w was 57.82 ± 28.59 months, with an average of 23.64 ± 12.40 injections administered. The BCVA was not significantly improved after Si4w. The CMT decreased significantly from 427.91 ± 125.74 μm to 336.38 ± 121.67 μm at the third visit (p < 0.001). Eighteen eyes (52.9%) showed complete resolution, and twenty-three eyes (67.6%) experienced complete resolution at least once during the three visits. The duration of fluid before Si4w was significantly associated with complete resolution (p = 0.011). Conclusions: Si4w of aflibercept showed satisfactory anatomical outcomes with complete resolution of fluid in patients with a limited response to bimonthly aflibercept injections, and should be considered as a useful treatment option.
摘要：
背景：本研究的目的是报告在难治性新生血管性年龄相关性黄斑变性（nAMD）患者中使用阿柏西普的治疗和扩展（TAE）方案（Si4w）将治疗间隔缩短至4周后的短期结果。方法：这项回顾性研究包括34例患者，当他们对每两个月一次的阿柏西普反应有限时，给予阿柏西普至少4周的TAE方案。比较Si4w前后的最佳矫正视力（BCVA）和中央黄斑厚度（CMT）。还检查了Si4w前后视网膜下液和视网膜内液的分辨率。分析与持续性液体相关的危险因素。结果：直到开始使用Si4w的平均治疗时间为57.82±28.59个月，平均23.64±12.40次注射。Si4w后BCVA没有显著改良。在第三次就诊时，CMT从427.91±125.74μm显着降低至336.38±121.67μm（p<0.001）。18只眼睛（52.9％）显示完全分辨率，在三次访问期间，有23只眼睛(67.6%)至少经历了一次完全分辨。在Si4w之前流体的持续时间与完全分辨率显著相关(p=0.011)。结论：阿柏西普的Si4w显示出令人满意的解剖学结果，对每两个月一次的阿柏西普注射反应有限的患者的液体完全消退，应被视为一种有用的治疗选择。
