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Tave van Zyl, Thanos D Papakostas, Laurence Shen Lim, John B Miller, Deeba Husain, Dean Eliott, Leo A Kim; Intravitreal Aflibercept for Macular Edema Secondary to Central Retinal Vein Occlusion in Patients with Prior Treatment with Bevacizumab or Ranibizumab. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4623. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the visual and anatomic outcomes of patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO) who were converted from either intravitreal bevacizumab or ranibizumab to intravitreal aflibercept due to persistent ME.
In this retrospective case series, 37 patients at a single academic retina practice were identified who had received at least 3 intravitreal injections of bevacizumab or ranibizumab prior to being switched to intravitreal aflibercept for persistence of ME secondary to CRVO. Visual acuity (VA) and central retinal thickness (CRT) were recorded and analyzed at 3 time points: immediately before switch to aflibercept, 1 month after first injection of aflibercept and at final follow-up visit. Mean injection interval before and after switch to aflibercept were compared, as were total number of bevacizumab, ranibizumab and aflibercept intravitreal injections.
Thirty-seven eyes of 37 patients were included. The median follow-up interval before switch to aflibercept was 11 months (range, 3-53.5) and 14 months (range, 1-22.2) after the switch. Mean VA before switch was 20/151, compared to 20/126 and 20/138 one month after the first injection of aflibercept and at the end of the follow-up interval, respectively (p=0.0853). Median CRT before switch was 539 μm, compared to 293 μm and 282.5 μm one month after the first injection of aflibercept and at the end of the follow-up interval, respectively (p=0.0032). The median number of weeks between injections before the switch was 5.6 and after the switch was 7.5 (p=0.0001).
Converting patients with persistent ME following CRVO to intravitreal aflibercept resulted in stabilization of visual acuity, improved macular anatomy and extension of injection interval.
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