September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Short-term outcomes of aflibercept therapy for diabetic macular edema in patients with incomplete response to ranibizumab and/or bevacizumab
Author Affiliations & Notes
  • Raphaelle Ores
    Service d’Ophtalmologie, Hôpital Lariboisière, AP-HP, Paris, France
  • Elise Philippakis
    Service d’Ophtalmologie, Hôpital Lariboisière, AP-HP, Paris, France
  • Pascale G Massin
    Service d’Ophtalmologie, Hôpital Lariboisière, AP-HP, Paris, France
  • Ramin Tadayoni
    Service d’Ophtalmologie, Hôpital Lariboisière, AP-HP, Paris, France
  • Benedicte Marie Dupas
    Service d’Ophtalmologie, Hôpital Lariboisière, AP-HP, Paris, France
  • Footnotes
    Commercial Relationships   Raphaelle Ores, None; Elise Philippakis, None; Pascale Massin, None; Ramin Tadayoni, None; Benedicte Dupas, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2107. doi:
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      Raphaelle Ores, Elise Philippakis, Pascale G Massin, Ramin Tadayoni, Benedicte Marie Dupas; Short-term outcomes of aflibercept therapy for diabetic macular edema in patients with incomplete response to ranibizumab and/or bevacizumab. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2107.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate the effects of aflibercept 2 mg on diabetic macular edema in patients with incomplete response to ranibizumab and/or bevacizumab.

Methods : Retrospective interventional study. Data from 9 consecutive patients with diabetic macular edema (DME) that showed incomplete response to ranibizumab 0.5 mg, and/or bevacizumab 1.25 mg and who were switched to aflibercept 2mg were collected. Incomplete response was defined on Spectral Domain-OCT (SD-OCT) by a decrease of central subfield foveal thickness (CSFT)< 20% four weeks after at least 3 monthly intravitreal injections of ranibizumab 0.5 mg, and/or bevacizumab 1.25 mg, and the persistence of fluid with a CSFT > 315 µm. Anatomic and functional responses were retrospectively assessed 4 weeks after at least 3 monthly intravitreal injections of aflibercept.

Results : Ten eyes of 9 patients were included (mean follow-up: 8.8±2.8 months). The mean age was 58.8±8.5 years and all patients had type 2 diabetes (median HbA1C 7.2%). Median duration of DME was 41 months (range 13-79) and baseline mean CSFT was 597±149 µm. Four weeks after 3 consecutive monthly intravitreal injections of aflibercept, 7 eyes over 10 (70%) showed an anatomic improvement (decrease of CSFT >20%) with a decrease in average CSFT from 529μm to 389μm (p=0.0026). No significant visual acuity (VA) gain was observed (from 0.44±0.2 to 0.39±0.27 LogMAR (p = 0.3)).

Conclusions : Our findings suggest that in patients with DME with persistent fluid on SD-OCT after at least 3 injections of ranibizumab 0.5 mg and/or bevacizumab 1.25 mg, a switch to intravitreal injections of aflibercept allowed to obtain an anatomic improvement in 70% of cases, with no additional VA gain.

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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