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2017 | 4 | 2 | 85-91
Article title

Poprawa efektu leczenia wysiękowej postaci zwyrodnienia plamki żółtej związanego z wiekiem po zmianie terapii afliberceptem na leczenie ranibizumabem

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Title variants
EN
Improvement of the therapeutic effect in age-related macular degeneration after switching therapy from aflibercept to ranibizumab
Languages of publication
PL
Abstracts
EN
The aim of the study: To evaluate anatomic and functional effects as well as the individual susceptibility to ranibizumab therapy in the absence of beneficial effects of aflibercept treatment in age-related macular degeneration. Material and Method: Ten patients, unsuccessfully treated with intravitreal aflibercept injections, were qualified for the ranibizumab injection program in AMD treatment. Ineffective treatment was understood as an increase in macular edema, and the resultant increase in central retinal thickness, and increased leakage in fluorescein angiography with an accompanying decrease in visual acuity and progression of changes on the Amsler grid. Following the treatment with ranibizumab injections, the above mentioned parameters were subject to further control. Results: Three patients experienced a reduction in central retinal thickness, edema and leakage area in fluorescein angiography, accompanied by reduced metamorphosis on the Amsler grid and stabilization or improvement of the best corrected visual acuity. Conclusion: The conversion of aflibercept therapy to ranibizumab therapy may be valuable for patients with no effective treatment with aflibercept. The problem requires further follow-up and assessment. Final conclusions might help design better methods for individual patient selection.
PL
Cel pracy: Oceniano anatomiczny i czynnościowy efekt (poprawa funkcji) oraz podatność osobniczą na ranibizumab przy braku korzyści z leczenia afliberceptem wysiękowej postaci zwyrodnienia plamki żółtej związanego z wiekiem. Materiał i metody: 10 chorych nieskutecznie leczonych iniekcjami doszklistkowymi afliberceptu zgłoszono do leczenia iniekcjami doszklistkowymi ranibizumabu. Brak skuteczności rozumiano jako wzrost obrzęku (i centralnej grubości siatkówki), zwiększenie przecieku w angiografii fluoresceinowej ze spadkiem ostrości widzenia i progresją zmian w teście Amslera. Po włączeniu nowego leczenia podlegały one dalszej kontroli. Wyniki: U 3 chorych stwierdzono zmniejszenie grubości siatkówki centralnej i obrzęku oraz obszaru przecieku wraz z towarzyszącą redukcją metamorfopsji w teście Amslera i stabilizacją lub poprawą najlepiej skorygowanej ostrości wzroku. Wniosek: Opisana konwersja może być wartościowa u osób niereagujących na aflibercept. Problem wymaga dalszych obserwacji i oceny na większej grupie, a wyciągnięte z nich wnioski mogą pozwolić na lepszy indywidualny dobór leku.
Discipline
Publisher

Journal
Year
Volume
4
Issue
2
Pages
85-91
Physical description
Contributors
author
  • Wojewódzki Szpital Okulistyczny w Krakowie
  • Wojewódzki Szpital Okulistyczny w Krakowie
  • Wojewódzki Szpital Okulistyczny w Krakowie
References
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  • 2. Rosenfeld PJ, Brown DM, Heier JS, et al; MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med 2006; 355(14): 1419-1431.
  • 3. ANCHOR Study Group. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology 2009; 116(1): 57-65.
  • 4. Miller JW, Le Couter J, Strauss EC, Ferrara N. Vascular endothelial growth factor a in intraocular vascular disease. Ophthalmology 2013; 120(1): 106-114.
  • 5. Stewart MW, Rosenfeld PJ. Predicted biological activity of intravitreal VEGF Trap. Br J Ophthalmol 2008; 92(5): 667-668.
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  • 7. Forooghian F, Cukras C, Meyerle CB, et al. Tachyphylaxis after intravitreal bevacizumab for exudative age-related macular degeneration. Retina 2009; 29(6): 723-731.
  • 8. Nudleman E, Wolfe J, Woodward M, et al. Worsening anatomic outcomes following aflibercept for neovascular age-related macular degeneration in eyes previously well controlled with ranibizumab. Clin Ophtalmol 2016; 10: 1053-1057 (erratum: Clin Ophtalmol 2017; 11: 355).
  • 9. Singh RP, Srivastava SK, Ehlers JP, et al. A single-arm, investigator-initiated study of the efficacy, safety, and tolerability of intravitreal aflibercept injection in subjects with exudative age-related macular degeneration previously treated with ranibizumab or bevacizumab (ASSESS study): 12-month analysis. Clin Ophthalmol 2015; 9: 1759-1766 (erratum: Clin Ophthalmol 2017; 11: 303).
  • 10. Bakall B, Folk JC, Boldt HC, et al. Aflibercept therapy for exudative age-related macular degeneration resistant to bevacizumab and ranibizumab. Am J Ophthalmol 2013; 156(1): 15-22.
  • 11. Yonekawa Y, Andreoli C, Miller JB, et al. Conversion to aflibercept for chronic refractory or recurrent neovascular age-related macular degeneration. Am J Ophthalmol 2013; 156(1): 29-35.
  • 12. Ho VY, Yeh S, Olsen TW, et al. Short-term outcomes of aflibercept for neovascular age-related macular degeneration in eyes previously treated with other vascular endothelial growth factor inhibitors. Am J Ophthalmol 2013; 156(1): 23-28.e2.
  • 13. Cho H, Shah CP, Weber M, Heier JS. Aflibercept for exudative AMD with persistent fluid on ranibizumab and/or bevacizumab. Br J Ophthalmol 2013; 97(8): 1032-1035.
  • 14. Kumar N, Marsiglia M, Mrejen S, et al. Visual and anatomical outcomes of intravitreal aflibercept in eyes with persistent subfoveal fluid despite previous treatments with ranibizumab in patients with neovascular age-related macular degeneration. Retina 2013; 33(8): 1605-1612.
  • 15. Abedi F, Wickremasinghe S, Richardson AJ, et al. Variants in the VEGFA gene and treatment outcome after anti-VEGF treatment for neovascular age-related macular degeneration. Ophthalmology 2013; 120(1): 115-121.
Document Type
article
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bwmeta1.element.psjd-de5488f4-cbfb-44ec-bd94-ee02fcb11c34
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