Purchase this article with an account.
Karen W Jeng, Greg Budoff, Howard F Fine, Daniel B Roth, jonathan prenner; Aflibercept (Eylea®) for Refractory Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1760.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To examine the clinical and anatomical effects of aflibercept in patients with refractory diabetic macular edema (DME).
A retrospective chart review with prospective follow-up was completed for all patients who received aflibercept for DME at a single multi-center retina practice for the three-month period after it became commercially available. Patients included in the cohort received 2 or more injections, one month apart, with a minimum follow up of at least 1 month after the last injection. Treatment-naïve eyes were excluded from the study. Outcome measures included central foveal thickness (CFT) measured on optical coherence tomography (OCT), best corrected visual acuity (BCVA), intraocular pressure (IOP), and presence of clinically significant macular edema (CSME) on funduscopic exam.
Seventeen eyes of 13 patients with DME were treated with aflibercept. Previous treatments among these patients included intravitreal ranibizumab (17), focal laser or pan-retinal photocoagulation (6), intravitreal steroid (5), and/or intravitreal bevacizumab (2). Mean BCVA remained constant from baseline to most recent follow up at 20/63 (p=1.0). There was no significant difference in IOP from baseline to most recent follow up (17.7 vs. 14.9, p=0.11). There was a significant decrease (17.3%) in the overall mean CFT from baseline to most recent follow up (375.5 microns vs. 310.5 microns, p=0.05). Among eyes with excessive foveal thicknesses (CFT ≥ 300 microns) (n=11 eyes), there was a 62.3% decrease in mean excess foveal thickness at the most recent follow up (132 microns vs. 49.8 microns, p=0.03). On funduscopic exam, 15 eyes demonstrated CSME on baseline exam, while only 12 eyes had CSME on exam at the most recent follow up. No complications were observed.
In highly treatment-experienced eyes with refractory DME, intravitreal aflibercept resulted in a statistically significant decrease in CFT. The reduction in CFT was most robust in eyes with excessive retinal thickness at baseline.
This PDF is available to Subscribers Only