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Quentin DUFOUR, Emilie Matamoros, Michele BOISSONNOT, Pierre INGRAND, Maher Saleh, Nicolas LEVEZIEL; MEDICARE study. Study design and time before recurrence of retinal neovascularization after anti-VEGF injections.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5806.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the delay of proliferative diabetic retinopathy recurrence after intravitreal injection of Aflibercept 2mg.
We performed a prospective, multicenter, randomized, clinical trial of intravitreal Aflibercept 2mg versus laser pan retinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR). Type 1 or 2 diabetes patients with a PDR detected with fluorescein angiography, without macular edema confirmed by SD-OCT, were randomized into 2 groups. Group 1 : PRP group and group 2 : three intravitreal injections of Aflibercept monthly followed by injections every two months the first year. Study visits occurred at 4weeks the first 3 months, then every 8 weeks until study completion at week 52. Each patient included in the study underwent blood pressure measurement, best corrected visual acuity, ocular exam, color fundus photographs and SD-OCT scans centered on the macula. Fluorescein angiography was performed at baseline, month 3, month 6 and month 12. After study completion, follow-up of patients was performed according to standard of care (fundus examination and fluorescein angiography if deemed necessary).
Eleven patients were randomized to receive laser photocoagulation, nine patients were randomized to receive Aflibercept. Among the 5 patients having completed the follow-up in the anti-VEGF group, 4 of them were classified mild non proliferative DR and 1 of them moderate non proliferative DR at the end of the study. Among them 2 patients showed recurrence of PDR at 8 months after the last anti-VEGF injection, 1 patient showed recurrence at 4 months after the last anti-VEGF injection and 2 patients were classified as severe non proliferative DR at 8 months after the last anti-VEGF injection.
Anti-VEGF injections for PDR could be an interesting option to PRP if the delay of recurrence after Aflibercept can be extended for several months. These preliminary results need to confirmed.
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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