Clinical observation of intravitreal injection of Conbercept treating idiopathic choroidal neovascularization_Chinese Journal of Ocular Fundus Diseases

Authors：

YuLan ,  ChenChangzheng , SuYu , YiZuohuizi , ZhouYunyun , QiHang , LiangChaoqun , XuYishuang

Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060;

Corresponding author：

ChenChangzheng, Email: whuchenchzh@163.com

Keywords：

Choroidal neovascularization/drug therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use

DOI：

10.3760/cma.j.issn.1005-1015.2016.01.004

Video：

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Objective To observe the clinical efficacy of intravitreal Conbercept on idiopathic choroidal neovascularization (ICNV). Methods This is an open and prospective study without control trial. Twelve eyes from 11 patients (7 females and 4 males) with ICNV diagnosed by best corrected visual acuity (BCVA), non-contact tonometer, ophthalmoscope, fundus photography, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) were enrolled in this study. All affected eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml) and received an average of (1.91±1.04) injections. The initial average letters of Early Treatment Diabetic Retinopathy Study (ETDRS) chart acuity were 61.73±14.58, range from 25 to 77. The patients were followed up for 6 to 9 months.The initial average central retinal thickness (CRT) was (330.73±47.79)μm, range from 290 to 467 μm. Best-corrected visual acuity (BCVA), OCT and ophthalmoscope examination were assessed monthly. Results During the 1, 3, 6 months after treatment, themean BCVA were all improved with statistically significant difference (t=2.68, 3.80, 3.65; P < 0.05). At 1 month later after treatment, the mean BCVA was obviously improved in 1 eye (9.09%), improved in 8 eyes (72.73%), stable in 1 eye (9.09%), decreased in 1 eye (9.09%). At 6 month later after treatment, the mean BCVA was obviously improved in 3 eyes (27.27%), improved in 6 eyes (54.55%), stable in 1 eye (9.09%), decreased in 1 eye (9.09%).During the 1, 3, 6 months after treatment, the mean CRT were all decreased with statistically significant difference(t=2.44, 3.78, 4.12; P < 0.05).At latest follow up, the leakage in macula lutea disappeared in 6 eyes(58.33%), decreased in 11 eyes (25%)and increased in 3 eyes (16.67%). There were no systemic or ocular serious side effects during the follow up. Conclusion Intravitreal Conbercept for ICNV showed CNV regression, retinal thickness reduction, visual acuity improvement and safety.

Citation： YuLan, ChenChangzheng, SuYu, YiZuohuizi, ZhouYunyun, QiHang, LiangChaoqun, XuYishuang. Clinical observation of intravitreal injection of Conbercept treating idiopathic choroidal neovascularization. Chinese Journal of Ocular Fundus Diseases, 2016, 32(1): 12-16. doi: 10.3760/cma.j.issn.1005-1015.2016.01.004 Copy

1.	Fukuchi T, Takahashi K, Ida H, et al. Staging of idiopathic choroidal neovascularization by optical coherence tomography[J]. Graefe's Arch Clin Exp Ophthalmol, 2001, 239(6):424-429.
2.	Fan C, Ji Q, Wang Y, et al. Clinical efficacy of intravitreal ranibizumab in early and mid-idiopathic choroidal neovascularization. J Ophthalmol, 2014, 2014: 382702.http://www.hindawi.com/journals/joph/2014/382702/.DOI:10.1155/2014/382702.
3.	Witmer AN, Vrensen GF, Van Noorden CJ, et al. Vascular endothelial growth factors and angiogenesis in eye disease[J]. Prog Retin Eye Res, 2003, 22(1):1-29.
4.	IInoue M, Kadonosono K, Watanabe Y, et al. Results of 1-year follow-up examinations after intravitreal bevacizumab administration for idiopathic choroidal neovascularization[J]. Retina, 2010, 30(5): 733-738. DOI: 10.1097/IAE.0b013e3181c9699c.
5.	Kim H, Lee K, Lee CS, et al. Subfoveal choroidal thickness in idiopathic choroidal neovascularization and treatment outcomes after intravitreal bevacizumab therapy [J]. Retina, 2014, 34(8): 1554-1559.DOI:10.1097/IAE.0000000000000354.
6.	Mandal S, Garg S, Venkatesh P, et al. Intravitreal bevacizumab for subfoveal idiopathic choroidal neovascularization[J]. Arch Ophthalmol, 2007, 125(11): 1487-1492.
7.	Shi X, Wei W, Zhang C. Intravitreal ranibizumab therapy versus photodynamic therapy for idiopathic choroidal neovascularization: a comparative study on visual acuity, retinal and choroidal thickness[J]. Chin Med J (Engl), 2014, 127(12): 2279-2285. DOI:10.3760/cma.j.issn.0366-6999.20140544.
8.	Cao XS, Peng XY, You QS, et al. Subfoveal choroidal thickness change after intravitreal ranibizumab for idiopathic choroidal neovascularization[J]. Retina, 2014, 34(8): 1554-1559. DOI: 10.1097/IAE.0000000000000122.
9.	叶湘湘, 陈中山, 丁琴, 等.玻璃体腔注射雷珠单抗与光动力疗法联合玻璃体腔注射雷珠单抗治疗特发性脉络膜新生血管的疗效比较[J].中华眼底病杂志, 2013, 29(4):362-366. DOI: 10.3760/cma.j.issn.1005-1015.2013.04.004.Ye XX, Chen ZS, Ding Q, et al. Intravitreal ranibizumab injection combined with or without photodynamic therapy for idiopathic choroidal neovascularization: a comparative efficacy study [J]. Chin J Ocul Fundus Dis, 2013, 29(4):362-366. DOI: 10.3760/cma.j.issn.1005-1015.2013.04.004.
10.	Zhang M, Zhang JJ, Yan M, et al. A phase 1 study of KH902, a vascular endothelial growth factor receptor decoy, for exudative age-related macular degeneration[J]. Ophthalmology, 2011, 118(4):672-678.DOI: 10.1016/j.ophtha.2010.08.008.
11.	张军军, 张美霞.湿性老年性黄斑变性治疗方法的新选择[J].中华实验眼科杂志, 2012, 30(11):961-964.DOI:10.3760/cma.j.issn.2095-0160.2012.11.001.Zhang JJ, Zhang MX. Choice of the treating methods of neovascular age-related macular degeneration[J]. Chin J Exp Ophthalmol, 2012, 30(11): 961-964. DOI:10.3760/cma.j.issn.2095-0160.2012.11.001.
12.	Li XX, Xu GZ, Wang YS. et al. Safety and efficacy of conbercept in neovascular age-related macular degeneration results from a 12-month randomized phase 2 study: AURORA Study Ophthalmology[J]. Ophthalmology, 2014, 121(9):1740-1747.DOI:10.1016/j.ophtha.2014.03.026.
13.	余岚, 陈长征, 易佐慧子, 等.玻璃体腔注射康柏西普治疗渗出型老年性黄斑变性的疗效观察[J].中华眼底病杂志, 2015, 31(1):256-259. DOI: 10.3760/cma.j.issn.1005-1015.2015.03.011.Yu L, Chen CZ, Yi ZHZ, et al. Clinical observation of intravitreal injection of Conbercept treating exudative age-related macular degeneration[J]. Chin J Ocul Fundus Dis, 2015, 31(1): 256-259. DOI: 10.3760/cma.j.issn.1005-1015.2015.03.011.
14.	戚沆, 陈长征, 易佐慧子, 等.玻璃体腔重复注射雷珠单抗对脉络膜新生血管患眼脉络膜厚度的影响[J].中华眼底病杂志, 2015, 31(1):31-35. DOI:10.3760/cma.j.issn.1005-1015.2015.01.009.Qi H, Chen CZ, Yi ZHZ, et al.Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization [J]. Chin J Ocul Fundus Dis, 2015, 31(1):31-35. DOI:10.3760/cma.j.issn.1005-1015.2015.01.009.
15.	张承芬, 陈有信.中心性渗出性脉络膜视网膜病变[M]//张承芬.眼底病学. 2版.北京:人民卫生出版社, 2010: 429-432.Zhang CF, Chen YX. Central exudative chorioretinopathy[M]//Zhang CF. Diseases of Ocular fundus. 2nd ed. Beijing:People's Medical Publishing House, 2010: 429-432.
16.	戴虹, 杨絮, 喻晓兵, 等.抗血管内皮生长因子单克隆抗体Ranibizumab治疗渗出型老年性黄斑变性临床观察[J].中华眼底病杂志, 2008, 24(3):160-163. DOI: 10.3760/cma.j.issn.1005-1015.2008.03.002.Dai H, Yang X, Yu XB, et al. Clinical observation of intravitreal injection of Ranibizumab for exudative age-related macular degeneration[J]. Chin J Ocul Fundus Dis, 2008, 24(3): 160-163.DOI: 10.3760/cma.j.issn.1005-1015.2008.03.002.
17.	Fung AE, Lalwani GA, Roseufeld PJ, et al.An optical coherence tomography guided, variable dosing regimen with intravitreal ranibizumab(Lucentis)for neovascular age-related macular degeneration[J].Am J Ophthalmol, 2007, 143(4): 566-583.
18.	Rosenfeld PJ, Brown DM, Heier JS, et al.Ranibizumab for neovascular age-related macular degeneration [J]. N Engl Med, 2006, 355(14): 1419-1431.
19.	Fung AE, Lalwani GA, Roseufeld PJ, et al. An optical coherence tomography guided, variable dosing regimen with intravitreal ranibizumab(Lucentis)for neovascular age-related macular degeneration[J]. Am J Ophthalmol, 2007, 143(4): 566-583.
20.	岳枚, 戴虹, 喻晓兵, 等.玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab治疗特发性脉络膜新生血管的临床观察[J].中华眼底病杂志, 2011, 27(6):510-514.DOI:10.3760/cma.j.issn.1005-1015.2011.06.003.Yue M, Dai H, Yu XB, et al. Clinical observation of intravitreal injection of ranibizumab for idiopathic choroidal neovascularization[J].Chin J Ocul Fundus Dis, 2011, 27(6):510-514. DOI:10.3760/cma.j.issn.1005-1015.2011.06.003.
21.	Miura ML, Iwasaki T, Goto H. Intravitreal aflibercept for polypoidal choroidal vasculopathy after developing ranibizumab tachyphylaxis [J]. Clin Ophthalmol, 2013, 7:1591-1595. DOI: 10.2147/OPTH.S50634.

1. Fukuchi T, Takahashi K, Ida H, et al. Staging of idiopathic choroidal neovascularization by optical coherence tomography[J]. Graefe's Arch Clin Exp Ophthalmol, 2001, 239(6):424-429.
2. Fan C, Ji Q, Wang Y, et al. Clinical efficacy of intravitreal ranibizumab in early and mid-idiopathic choroidal neovascularization. J Ophthalmol, 2014, 2014: 382702.http://www.hindawi.com/journals/joph/2014/382702/.DOI:10.1155/2014/382702.
3. Witmer AN, Vrensen GF, Van Noorden CJ, et al. Vascular endothelial growth factors and angiogenesis in eye disease[J]. Prog Retin Eye Res, 2003, 22(1):1-29.
4. IInoue M, Kadonosono K, Watanabe Y, et al. Results of 1-year follow-up examinations after intravitreal bevacizumab administration for idiopathic choroidal neovascularization[J]. Retina, 2010, 30(5): 733-738. DOI: 10.1097/IAE.0b013e3181c9699c.
5. Kim H, Lee K, Lee CS, et al. Subfoveal choroidal thickness in idiopathic choroidal neovascularization and treatment outcomes after intravitreal bevacizumab therapy [J]. Retina, 2014, 34(8): 1554-1559.DOI:10.1097/IAE.0000000000000354.
6. Mandal S, Garg S, Venkatesh P, et al. Intravitreal bevacizumab for subfoveal idiopathic choroidal neovascularization[J]. Arch Ophthalmol, 2007, 125(11): 1487-1492.
7. Shi X, Wei W, Zhang C. Intravitreal ranibizumab therapy versus photodynamic therapy for idiopathic choroidal neovascularization: a comparative study on visual acuity, retinal and choroidal thickness[J]. Chin Med J (Engl), 2014, 127(12): 2279-2285. DOI:10.3760/cma.j.issn.0366-6999.20140544.
8. Cao XS, Peng XY, You QS, et al. Subfoveal choroidal thickness change after intravitreal ranibizumab for idiopathic choroidal neovascularization[J]. Retina, 2014, 34(8): 1554-1559. DOI: 10.1097/IAE.0000000000000122.
9. 叶湘湘, 陈中山, 丁琴, 等.玻璃体腔注射雷珠单抗与光动力疗法联合玻璃体腔注射雷珠单抗治疗特发性脉络膜新生血管的疗效比较[J].中华眼底病杂志, 2013, 29(4):362-366. DOI: 10.3760/cma.j.issn.1005-1015.2013.04.004.Ye XX, Chen ZS, Ding Q, et al. Intravitreal ranibizumab injection combined with or without photodynamic therapy for idiopathic choroidal neovascularization: a comparative efficacy study [J]. Chin J Ocul Fundus Dis, 2013, 29(4):362-366. DOI: 10.3760/cma.j.issn.1005-1015.2013.04.004.
10. Zhang M, Zhang JJ, Yan M, et al. A phase 1 study of KH902, a vascular endothelial growth factor receptor decoy, for exudative age-related macular degeneration[J]. Ophthalmology, 2011, 118(4):672-678.DOI: 10.1016/j.ophtha.2010.08.008.
11. 张军军, 张美霞.湿性老年性黄斑变性治疗方法的新选择[J].中华实验眼科杂志, 2012, 30(11):961-964.DOI:10.3760/cma.j.issn.2095-0160.2012.11.001.Zhang JJ, Zhang MX. Choice of the treating methods of neovascular age-related macular degeneration[J]. Chin J Exp Ophthalmol, 2012, 30(11): 961-964. DOI:10.3760/cma.j.issn.2095-0160.2012.11.001.
12. Li XX, Xu GZ, Wang YS. et al. Safety and efficacy of conbercept in neovascular age-related macular degeneration results from a 12-month randomized phase 2 study: AURORA Study Ophthalmology[J]. Ophthalmology, 2014, 121(9):1740-1747.DOI:10.1016/j.ophtha.2014.03.026.
13. 余岚, 陈长征, 易佐慧子, 等.玻璃体腔注射康柏西普治疗渗出型老年性黄斑变性的疗效观察[J].中华眼底病杂志, 2015, 31(1):256-259. DOI: 10.3760/cma.j.issn.1005-1015.2015.03.011.Yu L, Chen CZ, Yi ZHZ, et al. Clinical observation of intravitreal injection of Conbercept treating exudative age-related macular degeneration[J]. Chin J Ocul Fundus Dis, 2015, 31(1): 256-259. DOI: 10.3760/cma.j.issn.1005-1015.2015.03.011.
14. 戚沆, 陈长征, 易佐慧子, 等.玻璃体腔重复注射雷珠单抗对脉络膜新生血管患眼脉络膜厚度的影响[J].中华眼底病杂志, 2015, 31(1):31-35. DOI:10.3760/cma.j.issn.1005-1015.2015.01.009.Qi H, Chen CZ, Yi ZHZ, et al.Choroidal thickness after intravitreal ranibizumab injections for choroidal neovascularization [J]. Chin J Ocul Fundus Dis, 2015, 31(1):31-35. DOI:10.3760/cma.j.issn.1005-1015.2015.01.009.
15. 张承芬, 陈有信.中心性渗出性脉络膜视网膜病变[M]//张承芬.眼底病学. 2版.北京:人民卫生出版社, 2010: 429-432.Zhang CF, Chen YX. Central exudative chorioretinopathy[M]//Zhang CF. Diseases of Ocular fundus. 2nd ed. Beijing:People's Medical Publishing House, 2010: 429-432.
16. 戴虹, 杨絮, 喻晓兵, 等.抗血管内皮生长因子单克隆抗体Ranibizumab治疗渗出型老年性黄斑变性临床观察[J].中华眼底病杂志, 2008, 24(3):160-163. DOI: 10.3760/cma.j.issn.1005-1015.2008.03.002.Dai H, Yang X, Yu XB, et al. Clinical observation of intravitreal injection of Ranibizumab for exudative age-related macular degeneration[J]. Chin J Ocul Fundus Dis, 2008, 24(3): 160-163.DOI: 10.3760/cma.j.issn.1005-1015.2008.03.002.
17. Fung AE, Lalwani GA, Roseufeld PJ, et al.An optical coherence tomography guided, variable dosing regimen with intravitreal ranibizumab(Lucentis)for neovascular age-related macular degeneration[J].Am J Ophthalmol, 2007, 143(4): 566-583.
18. Rosenfeld PJ, Brown DM, Heier JS, et al.Ranibizumab for neovascular age-related macular degeneration [J]. N Engl Med, 2006, 355(14): 1419-1431.
19. Fung AE, Lalwani GA, Roseufeld PJ, et al. An optical coherence tomography guided, variable dosing regimen with intravitreal ranibizumab(Lucentis)for neovascular age-related macular degeneration[J]. Am J Ophthalmol, 2007, 143(4): 566-583.
20. 岳枚, 戴虹, 喻晓兵, 等.玻璃体腔注射抗血管内皮生长因子单克隆抗体ranibizumab治疗特发性脉络膜新生血管的临床观察[J].中华眼底病杂志, 2011, 27(6):510-514.DOI:10.3760/cma.j.issn.1005-1015.2011.06.003.Yue M, Dai H, Yu XB, et al. Clinical observation of intravitreal injection of ranibizumab for idiopathic choroidal neovascularization[J].Chin J Ocul Fundus Dis, 2011, 27(6):510-514. DOI:10.3760/cma.j.issn.1005-1015.2011.06.003.
21. Miura ML, Iwasaki T, Goto H. Intravitreal aflibercept for polypoidal choroidal vasculopathy after developing ranibizumab tachyphylaxis [J]. Clin Ophthalmol, 2013, 7:1591-1595. DOI: 10.2147/OPTH.S50634.

Chinese Journal of Ocular Fundus Diseases

Clinical observation of intravitreal injection of Conbercept treating idiopathic choroidal neovascularization

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