Abstract
Purpose :
Eylea (Aflibercept) is an anti-angiogenic with a licence to treat macular oedema in CRVO patients. This was given NICE approval on 2014.1 We performed a retrospective, observational clinical study at our hospital in a 2 years cohort from 2014 to 2016 designed to look at the response of intravitreal aflibercept 2mg/ 0.05mL in treatment of macular oedema secondary to Central Retinal Vein Occlusion.
1 https://www.nice.org.uk/guidance/ta305, Published date: 26 February 2014
Methods :
All the patients received Aflibercept 2mg/0.05mL monthly for 5 months initially, with a follow up at 3, 6 and 12 months. Patients with residual macular oedema continued to receive monthly aflibercept injections.Visual acuity (VA) measured were converted to ETDRS equivalent for calculations. All patients had OCT done on Topcon 2000 OCT for measuring central macular thickness (CMT).
Results :
16 patients (19 eyes; N=19) different Ethnic origins from May 2014 to November 2016. The age ranged from 61-92 years. (mean 76.47, SD 8.32). There was equal number of male and female patients.The patients received an average of 5 injections at 6 months and 12 ±1 injections at 12 months.Mean VA before treatment was 37.105 ±24.456 ETDRS letters which improved to 52.857 ±17.288 at 3 months (P=0.0482). VA at 6 months was 40.625 ±23.655 (P=0.6696) & 12 months 26.785±29.457 (P=0.2804). Mean CMT before treatment was 526.5μ ± 183.736 which improved at 3 months to 321.866 μ ±230.037 (P= 0.0069), 6 months 318.267±176.066 (P=0.0021) & 12 months 442.5 μ ±216.859 (P=0.2569) respectively. No complications were noted post treatment. None of the patients required treatment for raised intra ocular pressure or rubeotic glaucoma.
43.75% of patients had 15 letter improvements at 3 months, 37.5% and 25% continued this improvement at 6 months and 12 months respectively.
Conclusions :
Aflibercept shows promising results in the treatment of macular oedema secondary to CRVO in the initial months; however the improvement was not maintained in our cohort at 12 months. Evaluation of a larger cohort is required to understand the role of Aflibercept in the management of macular oedema secondary to CRVO.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.