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Vaidehi Dedania, Cem Ozgonul, Cagri G Besirli; Aflibercept versus bevacizumab and/or ranibizumab for recurrent macular edema secondary to central retinal vein occlusion. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4287.
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© ARVO (1962-2015); The Authors (2016-present)
To compare functional and anatomic outcomes of treatment with intravitreal aflibercept versus bevacizumab and/or ranibizumab in patients with recurrent macular edema (ME) secondary to central retinal vein occlusion (CRVO).
Retrospective, comparative case series of patients with recurrent ME in the setting of CRVO. Patients with recurrent ME received treatment with aflibercept (Group 1, G1) or bevacizumab and/or ranibizumab (Group 2, G2). Primary outcome measures were best-corrected visual acuity (BCVA) and central foveal thickness (CFT).
Of the 20 eyes (20 patients) with recurrent ME included in the study, 9 received aflibercept (G1) and 11 received bevacizumab and/or ranibizumab (G2). Median BCVA at recurrence of ME and at most recent follow-up was 20/60 (G1) and 20/80 (G2) and 20/40 (G1) and 20/50 (G2, p> 0.05 for all comparisons), respectively. Median CFT at recurrence of ME and at most recent follow-up was 492 μm (G1) and 448 μm (G2) and 291 μm (G1) and 295 μm (G2, p> 0.05 for all comparisons), respectively. Complete resolution of ME for at least 4 months was found in 78% (G1) and 55% (G2) of patients with a median injection free interval of 11 (G1) and 13 (G2) months (p> 0.05).
In patients with recurrent ME secondary to CRVO, there was improvement in BCVA and CFT in all groups, although patients treated with aflibercept showed a trend toward better anatomical outcomes decreased need for recurrent injections.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) in Groups 1 and 2.* (A) There was a decline in BCVA in both groups at the time of recurrence, but improvement after treatment with aflibercept (Group 1) or bevacizumab and/or ranibizumab (Group 2). (B) CFT increased at the time of recurrence of macular edema and decreased after treatment with aflibercept (Group 1) and bevacizumab and/or ranibizumab (Group 2).
Figure 2. Spectral-domain optical coherence tomography of a patient in Group 1. A 72-year-old man with (A) complete resolution of macular edema (ME) after 3 injections of bevacizumab (BCVA 20/30, CFT = 297 μm), (B) recurrence of ME after 6 months (BCVA 20/50, CFT = 551 μm) and (C) complete resolution of ME after 4 monthly injections of aflibercept without recurrence 21 months after the last aflibercept injection (BCVA 20/25, CFT = 289 μm).
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