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Florentina Joyce Freiberg, Matthias Becker, Nicole Tracy Graf Johansen, Stephan Michels; Effect of intravitreal aflibercept in prior treated patients with persistent diabetic macular edema . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4624.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate functional and anatomic effects of intravitreal aflibercept 2.0 mg in cases of diabetic macular edema (DME) with persistent edema in optical coherence tomography (OCT) despite prior intravitreal therapy.
Retrospective review of patients with DME and persistent DME (central retinal thickness (CRT) ≥280 µm) despite prior therapy with ranibizumab 0.5 mg and/or bevacizumab 1.25 mg and/or triamcinolone 40mg/ml and/or dexamethasone 0.7 mg. All patients received three injections of 2.0 mg aflibercept at four week intervals and were followed for a minimum of 3 months. Primary endpoint was the change in CRT measured by spectral domain OCT following switch of therapy. Secondary endpoints included best corrected visual acuity (BCVA), intraocular pressure (IOP), and injection intervals.
A total of 27 eyes with persistent DME were included in the study. Patients received an average of 19.1 injections (min 5; max 46) prior to aflibercept with an average of 0.74 injections/month. The primary endpoint change in CRT showed a significant decrease from 416.5 µm to 315.1 µm (difference -114.8 µm; p = 0.003) three months after switch to aflibercept. BCVA before aflibercept and after the third aflibercept injection increased significantly from pre-treatment ETDRS 65.7 to post-treatment ETDRS 67.4 (p=0.031).
A switch to aflibercept in persistent DME under prior intravitreal therapy led to a significant increase in anatomical and functional outcomes. Further follow-up is required to evaluate if extended treatment intervals can be obtained.
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