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Michael Eric Jansen, Lyndon Tyler, Daniel Kermany, Jana Waters, Michael Singer; Comparing bevacizumab, ranibizumab, and aflibercept for early reduction of macular edema in patients with retinal vein occlusions (RVO).. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4156. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
There are several anti-VEGF agents used to treat macular edema in patients with RVO. This study is a retrospective chart review designed to evaluate and directly compare 3 anti-vegf drugs (Bevacizumab, Ranibizumab, and Aflibercept) and their effect on optical coherence tomography (OCT) central macular thickness (CMT) 2 weeks and 6 weeks after injection in patients with macular edema from retinal vein occlusions (BRVOs and CRVOs).
An IRB approved retrospective chart review was performed at a single center where records of patients who underwent combination therapy using an anti-VEGF agent (bevacizumab, ranibizumab, or aflibercept) and a dexamethasone intravitreal implant were analyzed.76 patients with macular edema from RVOs (BRVOs or CRVOs) were injected with bevacizumab, ranibizumab, or aflibercept. At 2 weeks these patients were injected with a dexamethasone intravitreal implant. Central macular thickness on OCT was obtained at baseline, at 2 weeks, and at 6 weeks. Outcome measures were mean CMT reduction and the percentage of patients who achieved an OCT CMT of < 300 μm at 2 and 6 weeks. A two-tailed t-test was used to compare the outcome measures between groups.
76 patients received Anti-VEGF injections (32 bevacizumab; 32 ranibizumab, 12 aflibercept) and a dexamethasone intravitreal implant. At 2 weeks, the aflibercept group had a mean (±standard error of mean [SEM]) CMT reduction of 39.9% ± 7.7%, the bevacizumab group had a 26.2% ± 3.4% mean CMT reduction, and the ranibizumab group had a 47% ± 3.5% mean CMT reduction (P < 0.0001). At 6 weeks, the aflibercept group had a 41.09% ± 6.5% mean CMT reduction, the bevacizumab group had a 31.6% ± 3.2% mean CMT reduction, and the ranibizumab group had a 52% ± 3.2% mean CMT reduction (P < 0.0001). At 2 weeks, 9% of bevacizumab patients, 78.1% of ranibizumab patients, and 83.3% of aflibercept patients achieved an OCT CMT < 300 μm. At 6 weeks, 56.3% of bevacizumab patients, 93.8% of ranibizumab patients, and 91.7% of aflibercept patients achieved an OCT CMT < 300 μm.
Ranibizumab and aflibercept appear to have a greater effect in decreasing OCT central macular thickness in the short-term compared to bevacizumab in patients with RVOs.
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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