Abstract
Purpose :
To determine the clinical effectiveness of aflibercept intravitreal injections (IVI) in treatment of patients with diabetic macular oedema.
Methods :
Single-centre retrospective study over 16 months (July 2014 - November 2015). 17 patients (21 eyes) with clinically significant diabetic macular oedema (DMO) treated with a minimum of 5 loading aflibercept injections were identified from Medisoft software. 1 patient was excluded as he had a concurrent central retinal vein occlusion. All patients followed the Scottish medical consortium (SMC) protocol, comprising of initial loading with 5 monthly injections of 0.5ml aflibercept, followed by 2-monthly injections for the next 3 visits, followed by a treat and extend regime. Primary outcomes were change in best corrected visual acuity (BCVA) in ETDRS letters and central retinal thickness (CRT) measured by optical coherence tomography (OCT).
Results :
16 patients (20 eyes) were included. 15 eyes had previously received Ranibizumab or Bevacizumab IVI and 5 eyes were treatment-naive. Mean age at first injection was 70 (53 – 89) years. Average number of injections was 5.85 (5-12) per eye. Mean follow-up was 7.9 (5.3-16.6) months. Following loading doses, BCVA improved in 18 (90%) eyes and worsened in 2 (10%). Patients on average gained 5.6 ETDRS letters with 20% gaining 1-5 letters, 45% gaining 6-10 letters and 25% gaining 11-15 letters. 2 eyes lost 1 or 12 letters. Results were sustained at last visit where average letter gain was 5.8 letters with 20% gaining 1-5 letters, 40% gaining 6-10 letters, 25% gaining 11-15 letters. 3 patients had reduced vision. All eyes had reduced CRT on OCT. Average CRT reduction was 186 microns after 5th loading injection and 184 microns on last visit.
Conclusions :
With the recommended treatment protocol, aflibercept has shown a good initial response in eyes with DMO in a small North-East Scotland cohort. Results are consistent with published one-year data from randomised clinical trials. This study demonstrates benefit of aflibercept in both treatment-naive and previously treated eyes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.