Abstract
Purpose :
To determine whether early response to anti-vascular endothelial growth factor (VEGF) therapy for diabetic macular edema(DME) is associated with its reactivity after 3 consecutive monthly injections.
Methods :
Seventy eyes of DME treated with anti-VEGF agents (average age 63.5±11.1 years, 16 eyes with 1.25-mg bevacizumab, 35 eyes with 0.5-mg ranibizumab and 19 eyes with 2.0-mg aflibercept) were enrolled. They were treated with 3 consecutive monthly injections. The BCVA (logMAR) and central macular thickness (CMT) at baseline / 1 week after initial injection / 1 month after 3 consecutive monthly injections were measured. The changes of both values 1) from baseline to 1week after initial injection (d7) and 2) from baseline to 1 month after 3 consecutive monthly injections (dL) were determined. The correlation between d7 and dL of BCVA/CMT values were evaluated.
Results :
The mean BCVA improved significantly for all 3 agents (0.38±0.22 at base line to 0.27±0.25 after consecutive monthly injections, p<0.05, repeated ANOVA). For all cases, moderate correlation was seen between BCVA of d7 and dL (p<0.01, r=0.58, Pearson correlation coefficient). No correlation was seen for bevacizumab (p=0.73. r=0.09), moderate correlation was seen for ranibizumab (p<0.05, r=0.42) and strong correlation was seen for aflibercept (p<0.001, r=0.83) between BCVA of d7 and dL. The mean CMT improved significantly for all 3 agents (481.9±96.3μm at base line to 364.1±116.0μm after consecutive monthly injections, p<0.05) and moderate correlation was seen between CMT of d7 and dL (p<0.01, r=0.54). Moderate correlation was seen for all 3 agents between CMT of d7 and dL (r=0.68 for bevacizumab, r=0.41 for ranibizumab and r=0.53 for aflibercept, p<0.01).
Conclusions :
The short term effects of anti-VEGF treatment for DME can predict the reactivity of therapy after 3 consecutive monthly injections and there may exist the difference between the 3 of anti-VEGF agents.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.