目的:探讨新生血管性年龄相关性黄斑变性(nAMD)患者从阿柏西普转换为法利单抗的疗效和结局,专注于视力,视网膜液管理,和治疗间隔。主要目的是评估阿柏西普难治性nAMD患者的早期结局,并探索法利单抗作为更持久治疗替代方案的潜力。
方法:自2022年9月至2023年5月在阿布扎比克利夫兰诊所对50名难治性nAMD患者进行了单中心回顾性研究。患者从阿柏西普改用法利单抗,符合难治性nAMD的具体标准。该研究分析了最佳矫正视力(BCVA),中心子场厚度(CST),和液体变化后的开关,使用光学相干断层扫描(OCT)。
结果:注射三次法利单抗后,观察到CST显著减少,视网膜液显着减少。平均BCVA在整个研究期间保持稳定。尽管最大色素上皮脱离(PED)高度有所下降,没有统计学意义。切换后的治疗间隔显示,大多数患者维持或延长了他们的治疗间隔,具有显著比例的视网膜内液(IRF)和视网膜下液(SRF)的分辨率。
结论:在难治性nAMD患者中,从阿柏西普改用法利克单抗可显著改善视网膜液管理和CST,具有稳定的BCVA结果。Faricimab为需要频繁注射阿柏西普的患者提供了一种有希望的替代方案,可能提供更易于管理的治疗方案,延长给药间隔.这项研究强调了在nAMD治疗中需要个性化的治疗策略,虽然进一步的研究是必要的,以优化治疗开关。
OBJECTIVE: To investigate the efficacy and outcomes of switching neovascular age-related macular degeneration (nAMD) patients from aflibercept to faricimab, focusing on visual acuity, retinal fluid management, and treatment intervals. The primary aim was to assess the early outcomes in nAMD patients refractory to aflibercept and explore faricimab\'s potential as a longer-lasting therapeutic alternative.
METHODS: A single-center retrospective study was conducted on 50 refractory nAMD patients at Cleveland Clinic Abu Dhabi from September 2022-May 2023. Patients were switched from aflibercept to faricimab, having met specific criteria for refractory nAMD. The study analyzed best-corrected visual acuity (BCVA), central subfield thickness (CST), and fluid changes post-
switch, using Optical Coherence Tomography (OCT).
RESULTS: After three faricimab injections, significant reductions in CST were observed, with a notable decrease in retinal fluid. The mean BCVA remained stable throughout the study period. Although there was a decrease in the maximum pigment epithelial detachment (PED) height, it was not statistically significant. Treatment intervals post-
switch showed that the majority of patients maintained or extended their treatment intervals, with a significant proportion achieving resolution of intraretinal fluid (IRF) and subretinal fluid (SRF).
CONCLUSIONS: Switching to faricimab from aflibercept in refractory nAMD patients led to significant improvements in retinal fluid management and CST, with stable BCVA outcomes. Faricimab presents a promising alternative for patients requiring frequent aflibercept injections, potentially offering a more manageable treatment regimen with extended dosing intervals. This study highlights the need for personalized therapeutic strategies in nAMD treatment, though further research is necessary to optimize treatment switches.