July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Anatomic Feature Dynamics and Perfusion Density Following Aflibercept Therapy in Retinal Vascular Disease in the PERMEATE Study
Author Affiliations & Notes
  • Natalia Albuquerque Lucena Figueiredo
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Sunil Srivastava
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Rishi P Singh
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Aleksandra V Rachitskaya
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Ming Hu
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Jamie Reese
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Laura Stiegel
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Neeley Dukles
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Jenna Hach
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Leina Lunasco
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Carmen Calabrise
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Eric Zhou
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Justis Ehlers
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Natalia Figueiredo, None; Sunil Srivastava, Allergan (F), Bausch and Lomb (C), Bioptigen (P), Leica (C), Santen (C), Synergetics (P), Zeiss (C); Rishi Singh, Alcon (C), Allergan (C), Genentech (C), Regeneron (C), Thrombogenics (C), Zeiss (C); Aleksandra Rachitskaya, Allergan (C); Ming Hu, None; Jamie Reese, None; Laura Stiegel, None; Neeley Dukles, None; Jenna Hach, None; Leina Lunasco, None; Carmen Calabrise, None; Eric Zhou, None; Justis Ehlers, Aerpio (F), Alcon (C), Alcon (F), Alimera Sciences (C), Allergan (C), Bioptigen/Leica (P), Genentech (C), Genentech (F), Leica/Bioptigen (C), Regeneron (F), Roche (C), Santen (C), Thrombogenics (C), Thrombogenics (F), Zeiss (C)
  • Footnotes
    Support  Regeneron VGFTe-DME-1431; NIH/NEI K23-EY022947-01A1
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 3596. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Natalia Albuquerque Lucena Figueiredo, Sunil Srivastava, Rishi P Singh, Aleksandra V Rachitskaya, Ming Hu, Jamie Reese, Laura Stiegel, Neeley Dukles, Jenna Hach, Leina Lunasco, Carmen Calabrise, Eric Zhou, Justis Ehlers; Anatomic Feature Dynamics and Perfusion Density Following Aflibercept Therapy in Retinal Vascular Disease in the PERMEATE Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3596.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : The specific impact of anti-VEGF therapy on retinal vascular dynamics, outer retinal integrity, and quantitative fluid parameters has not been fully explored. The purpose of this study was to evaluate these features in eyes with diabetic macular edema (DME) or retinal vein occlusion (RVO) undergoing therapy with intravitreal aflibercept injection (IAI) from the PERMEATE study.

Methods : PERMEATE is a prospective open-label study for treatment-naïve eyes with foveal-involving retinal edema secondary to DME or RVO. Subjects received IAI 2 mg monthly for the first 6 months. SD-OCT (Cirrus, Zeiss) scans were analyzed using a novel ellipsoid zone (EZ) and retinal fluid mapping tool. The output of the EZ mapping assessment including quantitative metrics of macular EZ-retinal pigment epithelium (RPE) volume, en face percentage of total EZ attenuation (EZ thickness = 0μm), and en face partial EZ attenuation (EZ thickness <20μm). In addition, volumetric assessment of subretinal fluid and intraretinal fluid metrics. OCT angiography perfusion density analysis (Avanti XR, Optovue) was utilized on the 3mm superficial and deep retinal plexus scans. All imaging was analyzed for baseline and 6-month visits.

Results : Twenty-three eyes had completed the 6-month follow-up with images that were sufficient quality for analysis. At 6-month there was a significant mean gain of 17.3 letters (p<0.001). EZ analysis demonstrated a significant increase in EZ-RPE volume (+10%, p=0.02) and EZ-RPE mean central subfield thickness (CST, +65%, p<0.001). Macular percentage of partial and total EZ attenuation also improved significantly at 6-month (-82% and -85%, respectively, p<0.02). IAI therapy resulted in a 94% reduction of intraretinal fluid volume at 6 months (p<0.001). Retinal perfusion density analysis demonstrated a 9% improvement in the superficial retinal plexus (p=0.01). EZ integrity parameters demonstrated significant correlation with final visual acuity, including percentage partial/total EZ attenuation and EZ-RPE mean CST (all p<0.0001).

Conclusions : Therapy with IAI resulted in significant improvement in multiple outer retinal integrity parameters, quantitative fluid burden, and improvements in superficial retinal perfusion at 6 months. Additional research is ongoing to explore potential imaging biomarkers for therapeutic response and confirming these findings in a larger study cohort.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×