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Antoine Herbaut, Lise Qu Knafo, Audrey Giocanti Auregan, Franck Fajnkuchen; Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab and/or intravitreal dexamethasone implant. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1891.
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The aim of this study was to evaluate the short-term functional and anatomical outcomes following conversion from ranibizumab or dexamethasone therapy to aflibercept for the treatment of refractory Diabetic Macular Edema (DME).
We conducted a retrospective study in a real life setting, including eyes with persistent DME after at least 3 injections of ranibizumab and/or one intravitreal dexamethasone implant. All patients received a loading dose of 3 injections of aflibercept and treated on an as-needed regimen. Our primary endpoint was the mean variation of visual acuity (VA) at 6 months of follow-up.
25 eyes of 21 patients were included. Before aflibercept conversion, 23 eyes received a median number of ranibizumab of about 9 injections and among them, 6 eyes received dexamethasone implant after ranibizumab. 2 eyes received one dexamethasone implant only before conversion to aflibercept. The mean follow-up was of 5.7 months. Baseline VA was of 57.1 + 19.6 letters. The mean gain of VA was +8 letters at 6 months of follow-up (p=0.006). The mean central retinal thickness (CRT) was 470.8 + 129.9 μm prior to conversion (SD-OCT, Cirrus 5000, Zeiss, Meditec). At 6 months of follow-up, the CRT improved to 303.3 + 59.1 μm, with a mean decrease of -167.5+149.3 μm (p<0.001).66,6% of patients had a CRT<300 μm at 6 months of follow-up. In this subgroup, VA improved of +11.1 letters (p=0.02).
Conversion to aflibercept after prior ranibizumab and/or dexamethasone treatment of DME, resulted in significant functional and anatomical improvements.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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