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Raphaelle Ores, Elise Philippakis, Pascale G Massin, Ramin Tadayoni, Benedicte Marie Dupas; Short-term outcomes of aflibercept therapy for diabetic macular edema in patients with incomplete response to ranibizumab and/or bevacizumab. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2107. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the effects of aflibercept 2 mg on diabetic macular edema in patients with incomplete response to ranibizumab and/or bevacizumab.
Retrospective interventional study. Data from 9 consecutive patients with diabetic macular edema (DME) that showed incomplete response to ranibizumab 0.5 mg, and/or bevacizumab 1.25 mg and who were switched to aflibercept 2mg were collected. Incomplete response was defined on Spectral Domain-OCT (SD-OCT) by a decrease of central subfield foveal thickness (CSFT)< 20% four weeks after at least 3 monthly intravitreal injections of ranibizumab 0.5 mg, and/or bevacizumab 1.25 mg, and the persistence of fluid with a CSFT > 315 µm. Anatomic and functional responses were retrospectively assessed 4 weeks after at least 3 monthly intravitreal injections of aflibercept.
Ten eyes of 9 patients were included (mean follow-up: 8.8±2.8 months). The mean age was 58.8±8.5 years and all patients had type 2 diabetes (median HbA1C 7.2%). Median duration of DME was 41 months (range 13-79) and baseline mean CSFT was 597±149 µm. Four weeks after 3 consecutive monthly intravitreal injections of aflibercept, 7 eyes over 10 (70%) showed an anatomic improvement (decrease of CSFT >20%) with a decrease in average CSFT from 529μm to 389μm (p=0.0026). No significant visual acuity (VA) gain was observed (from 0.44±0.2 to 0.39±0.27 LogMAR (p = 0.3)).
Our findings suggest that in patients with DME with persistent fluid on SD-OCT after at least 3 injections of ranibizumab 0.5 mg and/or bevacizumab 1.25 mg, a switch to intravitreal injections of aflibercept allowed to obtain an anatomic improvement in 70% of cases, with no additional VA gain.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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