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Robert L Avery; Incidence of New Choroidal Neovascularization in Fellow Eyes of Patients Treated with Intravitreal Aflibercept Injection or Ranibizumab in the VIEW studies. Invest. Ophthalmol. Vis. Sci. 2017;58(8):420.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate incidence of new choroidal neovascularization (CNV) in fellow eyes of patients treated for neovascular age-related macular degeneration (AMD) with intravitreal aflibercept injection (IAI) or ranibizumab in two similarly designed phase 3 clinical studies (VIEW1 and VIEW2).
Patients in both studies were randomized to ranibizumab 0.5 mg every 4 weeks (Rq4), IAI 2 mg every 4 weeks (2q4), IAI 0.5 mg every 4 weeks (0.5q4), or IAI 2 mg every 8 weeks following 3 initial monthly doses (2q8) over 52 weeks. From Weeks 52 to 96, patients were dosed at least quarterly with more frequent dosing allowed based on prespecified retreatment criteria. In this post hoc sub analysis, only fellow eyes lacking signs of neovascular AMD at baseline were included. Development of new CNV was based on adverse event reporting, concomitant medications, and fluorescein angiographic determination by an independent reading center. Kaplan-Meier methodology was employed to evaluate incidence of first observation of new CNV over 96 weeks. In addition, effect of select baseline factors (age, gender, and study eye characteristics [central retinal thickness, CNV lesion size, and intraretinal fluid]) were evaluated on incidence of new CNV in fellow eyes. Data from integrated VIEW studies are reported.
Proportions of fellow eyes at baseline without evidence of CNV in the Rq4, 2q4, 0.5q4, and 2q8 groups were 67.1%, 63.1%, 64.4%, and 63.6%, respectively. At Week 96, cumulative incidences of new CNV in these fellow eyes were similar across all treatment groups: 32.2%, 28.2%, 26.2%, 29.0% in the Rq4, 2q4, 0.5q4, and 2q8 groups, respectively. Baseline demographics associated with the occurrence of new CNV in fellow eyes were increasing age and being female. Larger CNV lesion size and presence of intraretinal fluid at baseline in the study eye was also associated with higher rates of new CNV in fellow eyes.
During two years of follow-up in the VIEW studies, incidence of new CNV in fellow eyes of patients treated with IAI or ranibizumab were similar across treatment groups indicating that treatment in the study eye was not a factor. The rate of new CNV development was higher in fellow eyes of patients whose study eyes presented with a larger CNV size and intraretinal fluid.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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