■血管内皮生长因子(VEGF)是参与视网膜屏障破坏的主要物质。VEGF过度表达可引起糖尿病性黄斑水肿(DME)。黄斑激光光凝术是DME的标准治疗方法;然而,最近,玻璃体内注射抗VEGF已超过激光治疗。我们的目的是评估玻璃体内注射阿柏西普或雷珠单抗治疗初治DME的疗效。
■这个单中心,回顾性,介入,对比研究纳入了在Al-Azhar大学医院玻璃体内注射阿柏西普2mg/0.05mL或雷珠单抗0.5mg/0.05mL的未治疗DME导致视力障碍的眼睛,2023年3月至2024年1月之间的埃及。收集基线和注射后1、3和6个月的人口统计学数据和完整的眼科检查结果,包括以最小分辨率角(logMAR)表示法的对数表示的最佳矫正远距视力(BCDVA),裂隙灯生物显微镜,扩张眼底镜检查,和使用谱域光学相干层析成像测量的中心子场厚度(CST)。
■总的来说,将96例中位(四分位距[IQR])年龄为57(10)(范围:20-74)岁,男女比例为1:2.7的患者的96只眼分配到两组中的一组,年龄相当,性别,糖尿病持续时间,并存在其他合并症(均P>0.05)。基线糖尿病视网膜病变状态或DME类型组间差异无统计学意义(均P>0.05)。在这两组中,中位数(IQR)BCDVA从基线时的0.7(0.8)logMAR显着改善至注射后6个月时的0.4(0.1)logMAR(均P=0.001),在所有随访中,组间差异无统计学意义(均P>0.05)。阿柏西普组的中位数(IQR)CST从基线时的347(166)µm显着降低至注射后6个月时的180(233)µm,雷珠单抗组从基线时的360(180)µm下降到注射后6个月时的190(224)µm(均P=0.001),在所有随访中,组间差异无统计学意义(均P>0.05)。两组均无严重不良反应记录。
雷珠单抗和阿柏西普在短期随访中对未治疗DME患者的解剖和功能结果同样有效,两种药物之间的注射计数没有显着差异。更大的前景,随机化,需要进行随访时间较长的双盲试验,以确认我们的初步结果.
UNASSIGNED: Vascular endothelial growth factor (VEGF) is the primary substance involved in retinal barrier breach. VEGF overexpression may cause diabetic macular edema (DME). Laser photocoagulation of the macula is the standard treatment for DME; however, recently, intravitreal anti-VEGF injections have surpassed laser treatment. Our aim was to evaluate the efficacy of intravitreal injections of aflibercept or ranibizumab for managing treatment-naive DME.
UNASSIGNED: This single-center, retrospective, interventional, comparative study included eyes with visual impairment due to treatment-naive DME that underwent intravitreal injection of either aflibercept 2 mg/0.05 mL or ranibizumab 0.5 mg/0.05 mL at Al-Azhar University Hospitals, Egypt between March 2023 and January 2024. Demographic data and full ophthalmological examination results at baseline and 1, 3, and 6 months post-injection were collected, including the best-corrected distance visual acuity (BCDVA) in logarithm of the minimum angle of resolution (logMAR) notation, slit-lamp biomicroscopy, dilated fundoscopy, and central subfield thickness (CST) measured using spectral-domain optical coherence tomography.
UNASSIGNED: Overall, the 96 eyes of 96 patients with a median (interquartile range [IQR]) age of 57 (10) (range: 20-74) years and a male-to-female ratio of 1:2.7 were allocated to one of two groups with comparable age, sex, diabetes mellitus duration, and presence of other comorbidities (all P >0.05). There was no statistically significant difference in baseline diabetic retinopathy status or DME type between groups (both P >0.05). In both groups, the median (IQR) BCDVA significantly improved from 0.7 (0.8) logMAR at baseline to 0.4 (0.1) logMAR at 6 months post-injection (both P = 0.001), with no statistically significant difference between groups at all follow-up visits (all P >0.05). The median (IQR) CST significantly decreased in the aflibercept group from 347 (166) µm at baseline to 180 (233) µm at 6 months post-injection, and it decreased in the ranibizumab group from 360 (180) µm at baseline to 190 (224) µm at 6 months post-injection (both P = 0.001), with no statistically significant differences between groups at all follow-up visits (all P >0.05). No serious adverse effects were documented in either group.
UNASSIGNED: Ranibizumab and aflibercept were equally effective in achieving the desired anatomical and functional results in patients with treatment-naïve DME in short-term follow-up without significant differences in injection counts between both drugs. Larger prospective, randomized, double-blinded trials with longer follow-up periods are needed to confirm our preliminary results.