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Michael Karampelas, Jacob Waxman, Foteini Faye Barampouti; Aflibercept versus ranibizumab for cystoid macular oedema secondary to central retinal vein occlusion. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4286.
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© ARVO (1962-2015); The Authors (2016-present)
To compare aflibercept and ranibizumab outcomes for cystoid macular oedema (CMO) secondary to central retinal vein occlusion (CRVO) in a "real-world" clinical setting.
We retrospectively compared outcomes in 100 eyes (60 receiving aflibercept injections and 40 eyes receiving ranibizumab injections). 3 loading doses were given monthly followed by per-needed injections. The follow period up was one year. There was no statistically significant difference between the two groups in any of the baseline characteristics.
No statistically significant difference in efficacy or number of injections was demonstrated. At one year, the functional and anatomical outcomes of aflibercept and ranibizumab were: mean visual acuity improvement 13.2 (±25.3) ETDRS letters vs. 4.8 (±11.2) (p=0.150), % gaining ≥15 letters 34% vs. 30%, % losing ≥15 letters 11% vs. 13%, mean CRT change -429.6 μm (±314.8) vs. -163.5 μm (±392.7) (p=0.123) and number of injections required 4.8±1.6 vs. 5.7±1.5 (p=0.1). In the total cohort, mean VA increased by 11±14.4 (p=0.023) letters and mean CRT reduction was 297.4±387.9 μm (p=0.000).
There was a trend of slightly better outcomes with aflibercept but it did not reached the statistically significant level at year one. Treatment outcomes of anti-VEGF intravitreal injections in the "real world" setting were inferior to the ones demonstrated in recent randomized clinical trials. This may be related to differences in treatment populations or the intensity of surveillance and treatment in trials compared to in the real world.
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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