Влияние нутрицевтика на комплексную терапию неоваскулярной возрастной макулярной дегенерации на фоне применения анти-VEGF препарата афлиберцепт

Abstract

Purpose. Evaluation of efficacy of aflibercept (Eylea®, Bayer, Germany) in combination with nutraceutical Ophtholique® (Sentiss Pharma, India) in treatment of neovascular agerelated macular degeneration (nAMD). Material and methods. 32 patients (32 eyes) with nAMD aged 54 to 75 years, controls – 12 healthy people of same age and gender. Initially, best-corrected visual acuity (BCVA) averaged 0.32±0.05. Clinical and morphological features of nAMD was macular neovascularization (MNV): in 18 patients – type 1; 14 people – type 2. All patients underwent 3 intravitreal injections of aflibercept. Two groups were formed, comparable in terms of BCVA and central retinal thickness (CRT), duration and severity of macular changes, gender, age: the main group (17 patients) – treatment was supplemented with Ophtholique®; comparison group (15 patients) – Ophtholique® was not prescribed. Results. After 1 month after 3 intravitreal injections of aflibercept, all 32 patients had no signs of disease activity. The interval between injections was increased according to the protocol by 2 weeks. After 6 months in the main group, the BCVA increased to 0.61 ± 0.02 due to regression of MNV, a decrease of CRT to control values was noted. In the comparison group, BCVA increased to 0.47 ± 0.03, CRT decreased to control values in 8 out of 15 patients. In 7 patients, BCVA, on the contrary, decreased to 0.30 ± 0.01, while the CRT increased to 421.5 ± 5.2 µm. By 12 months all patients of the main group showed none resumption of MNV activity, complete reattachment of neurosensory retina and pigment epithelium, resorption of intraretinal cystic cavities was noted. In the comparison group MNV activity was noted in 5 eyes with decrease in functional parameters of the retina. Conclusion. Combination of aflibercept in Tread-and-Extend treatment regimen with oral administration of nutraceutical Ophtholique® take it possible to increase efficacy of treatment of nAMD. Keywords: neovascular AMD, anti-VEGF therapy