June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Patients with Central Retinal Vein Occlusion require fewer injections when treated with aflibercept compared to ranibizumab using a treat-and-extend regimen: A prospective double-masked study
Author Affiliations & Notes
  • Manuel Casselholm de Salles
    St. Erik Eye Hospital, Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • Urban Amrén
    St. Erik Eye Hospital, Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • Anders P Kvanta
    St. Erik Eye Hospital, Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • David L Epstein
    St. Erik Eye Hospital, Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • Footnotes
    Commercial Relationships   Manuel Casselholm de Salles, None; Urban Amrén, None; Anders Kvanta, None; David Epstein, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2960. doi:
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      Manuel Casselholm de Salles, Urban Amrén, Anders P Kvanta, David L Epstein; Patients with Central Retinal Vein Occlusion require fewer injections when treated with aflibercept compared to ranibizumab using a treat-and-extend regimen: A prospective double-masked study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2960.

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

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Abstract

Purpose : Vascular endothelial growth factor (anti-VEGF) inhibitors are potent treatment options in patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO). Previous reports have suggested that aflibercept may have a longer duration compared to ranibizumab. However, there are no comparative trials on injection frequency with the two drugs in CRVO patients. We hypothesize that aflibercept has a longer duration than ranibizumab and that patients treated with aflibercept need fewer injections than subjects treated with ranibizumab when using a treat-and-extend regimen.

Methods : This was a prospective, randomized, double masked trial. Forty-five patients with treatment naïve CRVO and ME were randomized (1:1) to receive intravitreal injections with aflibercept or ranibizumab given in a treat-and-extend regimen. The primary outcome measure was the number of injections needed during the study period of 18 months. After 3 initial loading doses the treatment intervals were extended by 2-week intervals to a maximum of 12 weeks. Intervals were shortened by 2 weeks if ME recurred, as defined by intraretinal or subretinal fluid and central retinal thickness (CRT) of > 300 μm, (Cirrus Optical Coherence Tomography).

Results : Patients treated with aflibercept needed significantly fewer intravitreal injections compared to patients receiving ranibizumab (p=0.0017). There was no significant difference between the groups regarding visual acuity or CRT.

Conclusions : Patients with ME secondary to CRVO need significantly fewer intravitreal injections over an 18 month period when treated with aflibercept compared to ranibizumab when using a treat-and-extend regimen.

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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