.: ORİJİNAL ARAŞTIRMA
Assessment of Clinical Response to Aflibercept Treatment in Cases with Pigment Epithelial Detachment Associated with Neovascular Age-Related Macular Degeneration, Case Series
Neovasküler Yaşa Bağlı Makula Dejenerasyonu ile İlişkili Pigment Epitel Dekolmanı Olan Olgularda Aflibersept Tedavisine Klinik Yanıtın Değerlendirilmesi, Olgu Serileri
Turkiye Klinikleri J Ophthalmol. 2023;32(4):235-44
doi: 10.5336/ophthal.2023-98448
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: To evaluate the clinical results of intravitreal aflibercept in patients with pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration (nvAMD). Material and Methods: The study included 50 patients who were newly diagnosed with nvAMD and had not received treatment. Patients with PED-related nvAMD received three loading doses of intravitreal aflibercept. The patients were followed up with a pro re nata protocol at 16, 24, and 32 weeks. Age, gender, best corrected visual acuity (BCVA), PED type, and PED localisation were recorded. PED width, PED height, central macular thickness (CMT), and the presence of intraretinal fluid, and subretinal fluid were recorded at the time of application and at subsequent follow-up examinations. Results: There were statistically significant decreases both in CMT and PED height compared to baseline in all follow-up measurements (p<0.001, p<0.001, respectively). There was a statistically significant increase in BCVA compared to baseline only at 32 weeks (p=0.044). The types of PED were compared according to height and width values and a statistically significant decrease was observed in hollow type PED values at 16 and 32 weeks compared to solid type (p=0.011, p=0.029) and mixed type PED values (p=0.031, p=0.038). Conclusion: Intravitreal aflibercept treatment is effective in decreasing the height and width of PED and CMT anatomically and increasing the BCVA functionally. Furthermore, there was seen to be less improvement in solid and mixed PED types than in the hollow type.
Keywords: Pigment epithelial detachment; aflibercept; neovascular age related macula degeneration
Objective: To evaluate the clinical results of intravitreal aflibercept in patients with pigment epithelial detachment (PED) associated with neovascular age-related macular degeneration (nvAMD). Material and Methods: The study included 50 patients who were newly diagnosed with nvAMD and had not received treatment. Patients with PED-related nvAMD received three loading doses of intravitreal aflibercept. The patients were followed up with a pro re nata protocol at 16, 24, and 32 weeks. Age, gender, best corrected visual acuity (BCVA), PED type, and PED localisation were recorded. PED width, PED height, central macular thickness (CMT), and the presence of intraretinal fluid, and subretinal fluid were recorded at the time of application and at subsequent follow-up examinations. Results: There were statistically significant decreases both in CMT and PED height compared to baseline in all follow-up measurements (p<0.001, p<0.001, respectively). There was a statistically significant increase in BCVA compared to baseline only at 32 weeks (p=0.044). The types of PED were compared according to height and width values and a statistically significant decrease was observed in hollow type PED values at 16 and 32 weeks compared to solid type (p=0.011, p=0.029) and mixed type PED values (p=0.031, p=0.038). Conclusion: Intravitreal aflibercept treatment is effective in decreasing the height and width of PED and CMT anatomically and increasing the BCVA functionally. Furthermore, there was seen to be less improvement in solid and mixed PED types than in the hollow type.
Keywords: Pigment epithelial detachment; aflibercept; neovascular age related macula degeneration
ÖZET
Amaç: Bu çalışmanın amacı, neovasküler yaşa bağlı makula dejenerasyonu [neovascular age-related macular degeneration (nvAMD)] ile ilişkili pigment epitel dekolmanı (PED) olan hastalarda intravitreal afliberseptin klinik sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Çalışmaya yeni nvAMD tanısı almış ve tedavi almamış 50 hasta dâhil edildi. PED ile ilişkili nvAMD'si olan hastalara 3 yükleme dozu intravitreal aflibersept uygulandı. Hastalar 16, 24 ve 32. haftalarda pro re nata protokolü ile takip edildi. Yaş, cinsiyet, en iyi düzeltilmiş görme keskinliği [best corrected visual acuity (BCVA)], PED tipi ve PED lokalizasyonu kaydedildi. PED genişliği, PED yüksekliği, santral makula kalınlığı [central macular thickness (CMT)], intraretinal sıvı ve subretinal sıvı varlığı uygulama anında ve takip eden muayenelerde kaydedildi. Bulgular: Tüm takip ölçümlerinde başlangıca kıyasla hem CMT hem de PED yüksekliğinde istatistiksel olarak anlamlı düşüşler vardı (sırasıyla p<0,001, p<0,001). Sadece 32. Haftada başlangıca kıyasla BCVA'da istatistiksel olarak anlamlı bir artış oldu (p=0,044). PED tipleri boy ve genişlik değerlerine göre karşılaştırıldığında hollow tip PED değerlerinde 16 ve 32. haftalarda solid tip (p=0,011, p=0,029) ve mikst tip PED değerlerine (p=0,031, p=0,038) göre istatistiksel olarak anlamlı azalma gözlendi. Sonuç: İntravitreal aflibersept tedavisi anatomik olarak PED ve CMT'nin yükseklik ve genişliğini azaltmada ve fonksiyonel olarak BCVA'yı artırmada etkilidir. Ayrıca solid ve mikst PED tiplerinde hollow tipe göre daha az iyileşme olduğu görülmüştür.
Anahtar Kelimeler: Pigment epitel dekolmanı; aflibersept; neovasküler yaşa bağlı makula dejenarasyonu
Amaç: Bu çalışmanın amacı, neovasküler yaşa bağlı makula dejenerasyonu [neovascular age-related macular degeneration (nvAMD)] ile ilişkili pigment epitel dekolmanı (PED) olan hastalarda intravitreal afliberseptin klinik sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Çalışmaya yeni nvAMD tanısı almış ve tedavi almamış 50 hasta dâhil edildi. PED ile ilişkili nvAMD'si olan hastalara 3 yükleme dozu intravitreal aflibersept uygulandı. Hastalar 16, 24 ve 32. haftalarda pro re nata protokolü ile takip edildi. Yaş, cinsiyet, en iyi düzeltilmiş görme keskinliği [best corrected visual acuity (BCVA)], PED tipi ve PED lokalizasyonu kaydedildi. PED genişliği, PED yüksekliği, santral makula kalınlığı [central macular thickness (CMT)], intraretinal sıvı ve subretinal sıvı varlığı uygulama anında ve takip eden muayenelerde kaydedildi. Bulgular: Tüm takip ölçümlerinde başlangıca kıyasla hem CMT hem de PED yüksekliğinde istatistiksel olarak anlamlı düşüşler vardı (sırasıyla p<0,001, p<0,001). Sadece 32. Haftada başlangıca kıyasla BCVA'da istatistiksel olarak anlamlı bir artış oldu (p=0,044). PED tipleri boy ve genişlik değerlerine göre karşılaştırıldığında hollow tip PED değerlerinde 16 ve 32. haftalarda solid tip (p=0,011, p=0,029) ve mikst tip PED değerlerine (p=0,031, p=0,038) göre istatistiksel olarak anlamlı azalma gözlendi. Sonuç: İntravitreal aflibersept tedavisi anatomik olarak PED ve CMT'nin yükseklik ve genişliğini azaltmada ve fonksiyonel olarak BCVA'yı artırmada etkilidir. Ayrıca solid ve mikst PED tiplerinde hollow tipe göre daha az iyileşme olduğu görülmüştür.
Anahtar Kelimeler: Pigment epitel dekolmanı; aflibersept; neovasküler yaşa bağlı makula dejenarasyonu
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