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Holly Clarke, Anastasios Sepetis, Christina Rennie, Andrew Lotery, Debendra Sahu, Dario Inzerillo, Bhaskar Gupta; Efficacy of Aflibercept for the treatment of diabetic macular oedema in patients refractory to Ranibizumab.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3606. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Patients with Diabetic Macular Oedema (DMO) might exhibit subclinical response to a specific anti- Vascular Endothelial Growth Factor (anti-VEGF). We performed a retrospective audit to investigate the efficacy of Aflibercept in patients with DMO who had previously received Ranibizumab.
Patients with clinically significant macular oedema that were converted from Ranibizumab to Aflibercept, were investigated retrospectively to evaluate visual and anatomical characteristics at 3, 6, 9 and 12 months after the switch. More specifically, the outcome measures studied were best corrected visual acuity (VA) and central macular thickness (CMT).
We identified 62 eyes from 48 patients (mean age 64.7 years) that had received 11.4 injections prior to switch (range). At baseline VA in LogMAR and CMT were 0.45(-0.08-1.06) and 452.02μm(283-749), respectively.VA at 6 and 12 months was significantly improved to 0.38±0.24 (p<0.001) and 0.40± 0.27 (p<0.05) comparing to baseline, respectively (mean±SD, paired t test).CMT at 6 and 12 months was significantly reduced to 367.30±95.84μm and 357.82± 75.69μm comparing to baseline, respectively (mean±SD, p<0.0001, paired t test).The eyes received a mean of 3.62 (1-6) injections at month 6 and 5.97 (1-10) injections at month 12.At 12 months, 20% of the eyes gained more than 2 lines, 5% lost more than 2 lines while 75% remained within 2 lines comparing to baseline. No injection related complications were identified.
Statistical significant structural improvement can be achieved by switching from Ranibizumab to Aflibercept in patients who do not respond to the former. In the majority of patients receiving Aflibercept vision seems to be maintained. Patients and health services may benefit from less frequent visits. However, alternative therapeutic pathways must be explored.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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