Real world results of aflibercept treatment for macular oedema secondary to central retinal vein occlusions

Abstract

Purpose : Macular oedema (MO) secondary to central retinal vein occlusions (CRVO) is one of the most common indications for anti-VEGF treatment. We present real world results of patients with MO secondary to CRVO treated with Aflibercept with either a treat and extend (T+E) or pro re nata (PRN) regimen.

Methods : A retrospective cohort study was carried out. Records of patients attending for anti-VEGF treatment between January 2011 and June 2017 were reviewed. Inclusion criteria was treatment naieve patients diagnosed with MO secondary to CRVO undergoing treatment with aflibercept for a minimum of 6 months. Exclusion criteria included co-existing retinal pathology. Patients were split into two groups; those who underwent T+E and those who underwent PRN treatment. Electronic records were reviewed and data for patient demographics, and baseline, 6 month and 12 months visual acuity (VA) and central macular thickness (CMT) was recorded.

Results : 38 patients were included. Mean age was 70.0 years (SD 13.2). Male to female ratio was 13:25. 16 patients were in the T+E group, and 22 in the PRN group. Mean number of visits per year in the T+E group was 5.7 (SD 1.5) and 10.2 (SD 2.5) in the PRN group which was statistically significant (p < 0.001). Mean number of injections per year in the T+E group was 7.2 (SD 1.8) and 7.5 (SD 2.9) in the PRN group. There was no statistical significance between the two groups (p=0.86). There was no difference in baseline VA between the two groups (p=0.94) or baseline CMT (p=0.62). In the T+E group change in VA from baseline at 6 months was 25.4 letters (SD 19.9), and at 12 months 18.2 letters (SD 33.5). In the PRN group change in VA from baseline at 6 months was 13.7 letters (SD 19.5) and at 12 months 16.0 letters (SD 16.5). There is no statistical difference in change in VA at 6 months (p =0.13) or at 12 months (p =0.44). In the T+E group change in CMT from baseline at 6 months was -307.25 (SD 93.7) and at 12 months -261.7 (SD 169.1). In the PRN group change in CMT from baseline at 6 months was -203.0 (SD 205.4) and at 12 months -248.8 (SD 269.8). There is a statistical difference in change in CMT at 6 months (p=0.09) but not at 12 months (p=0.9) between the two groups.

Conclusions : Treatment with Aflibercept in patients with MO secondary to CRVO using a T+E regimen has comparable outcomes to PRN treatment but with significantly lower number of mean visits per year.

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