Abstract
Purpose :
Vascular endothelial growth factor (anti-VEGF) inhibitors are potent treatment options in patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO). Previous reports have suggested that aflibercept may have a longer duration compared to ranibizumab. However, there are no comparative trials on injection frequency with the two drugs in CRVO patients. We hypothesize that aflibercept has a longer duration than ranibizumab and that patients treated with aflibercept need fewer injections than subjects treated with ranibizumab when using a treat-and-extend regimen.
Methods :
This was a prospective, randomized, double masked trial. Forty-five patients with treatment naïve CRVO and ME were randomized (1:1) to receive intravitreal injections with aflibercept or ranibizumab given in a treat-and-extend regimen. The primary outcome measure was the number of injections needed during the study period of 18 months. After 3 initial loading doses the treatment intervals were extended by 2-week intervals to a maximum of 12 weeks. Intervals were shortened by 2 weeks if ME recurred, as defined by intraretinal or subretinal fluid and central retinal thickness (CRT) of > 300 μm, (Cirrus Optical Coherence Tomography).
Results :
Patients treated with aflibercept needed significantly fewer intravitreal injections compared to patients receiving ranibizumab (p=0.0017). There was no significant difference between the groups regarding visual acuity or CRT.
Conclusions :
Patients with ME secondary to CRVO need significantly fewer intravitreal injections over an 18 month period when treated with aflibercept compared to ranibizumab when using a treat-and-extend regimen.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.