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Pallavi Tyagi, Zain Juma, Loreena Bilal, Cynthia Santiago; Initial results of intravitreal Aflibercept (Eylea) in diabetic macula oedema in North-East Scotland.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2096.
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To determine the clinical effectiveness of aflibercept intravitreal injections (IVI) in treatment of patients with diabetic macular oedema.
Single-centre retrospective study over 16 months (July 2014 - November 2015). 17 patients (21 eyes) with clinically significant diabetic macular oedema (DMO) treated with a minimum of 5 loading aflibercept injections were identified from Medisoft software. 1 patient was excluded as he had a concurrent central retinal vein occlusion. All patients followed the Scottish medical consortium (SMC) protocol, comprising of initial loading with 5 monthly injections of 0.5ml aflibercept, followed by 2-monthly injections for the next 3 visits, followed by a treat and extend regime. Primary outcomes were change in best corrected visual acuity (BCVA) in ETDRS letters and central retinal thickness (CRT) measured by optical coherence tomography (OCT).
16 patients (20 eyes) were included. 15 eyes had previously received Ranibizumab or Bevacizumab IVI and 5 eyes were treatment-naive. Mean age at first injection was 70 (53 – 89) years. Average number of injections was 5.85 (5-12) per eye. Mean follow-up was 7.9 (5.3-16.6) months. Following loading doses, BCVA improved in 18 (90%) eyes and worsened in 2 (10%). Patients on average gained 5.6 ETDRS letters with 20% gaining 1-5 letters, 45% gaining 6-10 letters and 25% gaining 11-15 letters. 2 eyes lost 1 or 12 letters. Results were sustained at last visit where average letter gain was 5.8 letters with 20% gaining 1-5 letters, 40% gaining 6-10 letters, 25% gaining 11-15 letters. 3 patients had reduced vision. All eyes had reduced CRT on OCT. Average CRT reduction was 186 microns after 5th loading injection and 184 microns on last visit.
With the recommended treatment protocol, aflibercept has shown a good initial response in eyes with DMO in a small North-East Scotland cohort. Results are consistent with published one-year data from randomised clinical trials. This study demonstrates benefit of aflibercept in both treatment-naive and previously treated eyes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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