April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Aflibercept therapy for diabetic macular edema resistant to ranibizumab and bevacizumab
Author Affiliations & Notes
  • Peter Karth
    Byers Eye Institute, Stanford University, Department of Ophthalmology, Palo Alto, CA
  • Darius M Moshfeghi
    Byers Eye Institute, Stanford University, Department of Ophthalmology, Palo Alto, CA
  • Theodore Leng
    Byers Eye Institute, Stanford University, Department of Ophthalmology, Palo Alto, CA
  • Footnotes
    Commercial Relationships Peter Karth, None; Darius Moshfeghi, Convene (I), Genentech (E), Grand Legend Tech (I), Oraya Theraputis (I), Realm Global (I), Synergetics (I), Thrombogenics (I), VersaVision (I); Theodore Leng, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1775. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Peter Karth, Darius M Moshfeghi, Theodore Leng; Aflibercept therapy for diabetic macular edema resistant to ranibizumab and bevacizumab. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1775.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose: To evaluate the anatomic and visual acuity outcomes of intravitreal aflibercept 2.0 mg in cases of diabetic macular edema (DME) with persistent fluid on spectral domain optical coherence tomography (SD-OCT) despite regular intravitreal injections (IVI) of ranibizumab 0.5 mg and/or bevacizumab 1.25 mg.

Methods: In this retrospective interventional case series, DME patients with persistent retinal fluid despite regular IVI therapy with ranibizumab 0.5 mg and/or bevacizumab 1.25 mg were switched to IVI aflibercept 2.0 mg. Collected data includes details of prior treatments, best available visual acuity, central subfield thickness (CST), and the area of thickest edema on registered SD-OCT before and after aflibercept IVI.

Results: A total of 13 eyes with persistent DME were included. All eyes had persistent fluid after at least 3 monthly ranibizumab or bevacizumab IVIs (range 3-12). At 1 month after the first aflibercept IVI, 77% (10/13 eyes) showed anatomic improvement although none were fluid free; 23% (3/10 eyes) showed stable or worsening edema. On average, CST decreased from 411 to 332 microns (19%; p<0.023) after one aflibercept IVI. When measuring the thickest point in the macula on registered SD-OCT, the thickness decreased from 536 to 466 microns (13%; p<0.030) after one aflibercept IVI. All eyes followed over multiple aflibercept injections showed further improvement (3 eyes). Visual acuity improved in 3 of 10 eyes one month after the first aflibercept IVI (p=0.61). Treatment was well tolerated with no adverse events.

Conclusions: A majority of DME cases with persistent fluid on SD-OCT despite regular ranibizumab 0.5 mg and/or bevacizumab 1.25 mg IVIs showed a positive anatomic response to aflibercept 2.0 mg. IVI aflibercept appears to be anatomically beneficial in cases of DME with persistent fluid despite treatment with ranibizumab and/or bevacizumab.

Keywords: 505 edema • 499 diabetic retinopathy • 748 vascular endothelial growth factor  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×