Purchase this article with an account.
Maximilian Pfau, Heidi Fassnacht-Riederle, Matthias Becker, Stephan Michels; Clinical outcome after switching therapy from ranibizumab and/or bevacizumab to aflibercept in Central Retinal Vein Occlusion (CRVO): 1 year results . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4625.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
After 48 months, unresolved macular edema secondary to central retinal vein occlusion (CRVO) is present in more than half of the patients treated with ranibizumab/bevazicumab. The here presented retrospective, observational clinical study examines, whether switching therapy to aflibercept, improves the clinical outcome in patients with CRVO, who have previously responded insufficiently to ranibizumab/bevacizumab.
The presented study is a retrospective analysis of CRVO patients (n=13), who initially responded insufficiently to ranibizumab/bevacizumab. Insufficient response was defined as necessity of injections every 6 weeks or more frequently to resolve macular edema. Treatment in these patients was switched to aflibercept, which was administered based on a ‘treat and extend’ regime. The injection interval, relapse-free interval, central retinal thickness, central retinal volume, visual acuity and IOP were evaluated prior to, at month 6 and at month 12 after switching therapy. The statistical analyses were performed using SPSS® Version 20. Since distributions were not normal, non-parametric tests were performed for all analyses. Dependent samples were tested with the exact Wilcoxon signed rank test.
The mean injection interval increased from 1.20 months at baseline to 1.69 months at month 12 after switching therapy to aflibercept (p=0.030). Likewise, the maximal relapse-free interval increased from 4.75 weeks at baseline to 7.63 weeks at month 6 and to 7.68 weeks at month 12 (p=0.011). In accordance to the aforementioned, between baseline and month 12 the mean central retinal thickness decreased by 327.38 µm (p=0.012) and the mean central retinal volume (6 mm diameter) by -2.91 mm3 (p=0.012). Correspondingly, the mean ETDRS score increased from 66.00 at baseline to 76.25 letters at month 12 after switching therapy to aflibercept (+ 10.25 letters, p=0.031). The mean IOP was not statistically significant affected between baseline and month 12 (-1.56 mmHg, p=0.26).
Switching therapy from intravitreal ranibizumab/bevacizumab to aflibercept in insufficiently responding macular edema secondary to CRVO elongates the injection interval and the relapse-free interval. Furthermore, switching therapy to aflibercept provides an improved anatomical as well as functional outcome.
This PDF is available to Subscribers Only