ObjectiveTo explore the conversion treatment value of Faricimab in patients with neovascular age-related macular degeneration (nAMD) who had sub-optimal response to anti-vascular endothelial growth factor (VEGF) drug therapy, and to preliminarily evaluate its clinical effect. MethodsA retrospective clinical study. From March 2024 to January 2025, 25 patients (32 eyes) diagnosed with nAMD at Department of Ophthalmology of General Hospital of Central Theater Command were included in the study. All affected eyes were converted to receive Faricimab treatment due to sub-optimal response to previous anti-VEGF drug therapy. The treatment plan is to provide treatment as needed after the first injection based on the follow-up results. The best corrected visual acuity (BCVA) and swept-source optical coherence tomography angiography (SS-OCTA) were evaluated. BCVA examination was conducted using the Snellen visual acuity chart and converted to the logarithm of the minimum angle of resolutionn (logMAR) visual acuity for statistical analysis. The SS-OCTA system automatically calculates indicators such as central retinal thickness (CRT), choroidal neovascularization surface area (CSA), and choroidal neovascularization flow area (CFA). The main observations were made on the changes of BCVA, CSA, CFA, CRT and adverse reactions at 1, 3 and 6 months after treatment. A mixed linear model was adopted to compare the differences between each index and the baseline. ResultsAmong the 25 patients, 20 were male (80.0%, 20/25) and 5 were female (20.0%, 5/25). Age was (66.6±11.2) years old. The disease course was (41.2±36.4) months. Previously received anti-VEGF drug treatment (20.5±21.6) times, involving 2.2 types of drugs. Among the 32 eyes, 16 (50.0%), 11 (34.4%), and 7 (21.9%) eyes had subretinal fluid, intraretinal fluid, and both coexisting, respectively. At baseline, the logMAR BCVA of the affected eye was 0.67±0.41, the CSA and CFA were (7.46±6.27) and (3.26±2.59) mm2, respectively, and the CRT was (380.75±147.56) μm. At 1, 3, and 6 months after switching to Faricimab treatment, logMAR BCVA improved to 0.57±0.42, 0.55±0.41, and 0.50±0.35, respectively. The corresponding CSA were (6.36±6.10), (6.44±6.12), and (6.44±5.96) mm2. The corresponding CFA values were (2.79±2.50), (2.35±2.25), and (2.59±2.35) mm2. The corresponding CRT were (330.64±147.56), (329.44±130.73), (340.05±144.56) μm. Compared with the baseline, BCVA significantly improved at each time point after treatment, and CSA and CFA significantly decreased. The differences were statistically significant (P＜0.05). At 1 and 3 months after treatment, CRT was significantly lower than the baseline, and the difference was statistically significant (P=0.005, 0.025). During the follow-up period, the intraocular pressure of all affected eyes remained normal, and no serious adverse events such as intraocular infection occurred. ConclusionFor nAMD patients with poor response to anti-VEGF drug treatment, switching to Faricimab treatment can effectively improve the BCVA and anatomical structure (including CSA, CFA and CRT) of the affected eyes, and has good safety.
【Abstract】 Objective To study the expressions of cyclooxygenase-2 (Cox-2) and angiopoietin-2 (Ang-2) in colorectal cancer tissues, cancer adjacent tissues and normal colorectal tissues, and the relationship between these expressions and the clinicopathologic features of colorectal cancer. Methods Forty-five excised samples of colorectal adenocarcinoma were confirmed pathologically and 39 of them were of well or moderately differentiated and 6 of poorly differentiated. Lymph nodes metastasis developed in 30 patients. And 15 cases were in stage of A or B and the rest were in the stage of C or D according to the Dukes stage. Taken PBS as the negative control and the verified Cox-2 or Ang-2 positive sections as positive controls, this study detected the expressions of Cox-2 and Ang-2 protein in 45 colorectal cancer tissues, 45 cancer adjacent tissues and 15 normal colorectal tissues by using immunohistochemical SP technique method. Results Cox-2 and Ang-2 were expressed in colorectal cancer tissues and cancer adjacent tissues, but were not expressed in normal colorectal tissues. In 45 colorectal cancer tissues, the positive expression rates of Cox-2 and Ang-2 were 80.0% and 66.7%; in 45 cancer adjacent tissues, the positive expression rates of Cox-2 and Ang-2 were 35.6% and 11.1%, respectively. The positive expression rates of both Cox-2 and Ang-2 in colorectal cancer tissues were significantly higher than those in cancer adjacent and normal colorectal tissues. There were close correlations between the expressions of Cox-2 and Ang-2 and some pathologic features, such as lymph node metastasis and Dukes stage; whereas there were no significant association between the expressions and gender, histological type and position of tumor. There was also a close correlation between the expressions of Cox-2 and Ang-2 themselves. Conclusion Cox-2 and Ang-2 play an important role in the occurrence and development of colorectal cancer. The use of specific inhibitor of Cox-2 as a treatment for colorectal cancer may become feasible and necessary.
