Abstract
Purpose :
Evaluate the macular thickness (MT) and visual acuity (BCVA) after the treatment with aflibercept (A) plus ranibizumabe (R) with dexamethasone (D) intravitreal injection (IV) in eyes with Diabetic Macular Edema (DME).
Methods :
Four groups randomly selected and submitted to alternating treatment with A (G1), R (G2), A + D (G3), R+ D (G4), 1D + 2A + 1R (G5) and 1D + 1A + 2R (G6).
A randomized clinical trial was conducted in patients diagnosed with DME from January 2017 to October 2018, in order to evaluate and compare the efficacy of this disease according to BCVA and MT using the joint treatment with A or R or A + R with D intravitreous.
Interventions were perform with IV in 24 eyes with formal indications of DME treatment previously evaluated with complete eye exam from January 2017 to October 2018.
The patients were dived into 6 groups (4 eyes per group):
- Group 1 were performed 3 IV of A 0.1ml, with 1 application per month (p/m);
- Group 2 were performed 3 IV of R 0.1ml, with 1 application p/m;
- Group 3 were performed 1 IV of D + 3 IV of A 0.1ml, with 1 application p/m;
- Group 4 were performed 1 IV of D + 3 IV of R 0.1ml, with 1 application p/m;
- Group 5 were performed 1 IV of D+ 2 IV of R 0.1ml and 1 application of A 0.1ml, with 1 application p/m;
- Group 6 were performed 1 IV of D + 2 IV of A0.1ml +1 IV of R 0.1ml, with 1 application p/m.
All groups were monitoring with OCT on days 7 and 30 subsequent to application.
Results :
Was observed in patients subjected the applications of A plus R with D (G5) or R + A with D (G6) application there was a DME reduction of about 56.04% one week after the third IV of antiangiogenic. In patients subjected the applications of A + D (G3) or R + D (G4) application there was a DME reduction of about 52.32% 1 week after the third IV of antiangiogenic, being superior to the other groups (A or R). Was similar to the reduction observed with the G1 or G2 in which it was observe 32.82% and 30.23% reduction in DME.
The BCVA observed a constant improvement in the 6 groups, 2 lines in G1 and G2, but 4 lines in G3, G4, G5 and G6 (according to the scale of Snellen).
Conclusions :
We can state through this study that the treatment of DME with anti-VEGF associate with corticosteroid has a greater benefit than the treatment with these drugs alone, shown by OCT. BCVA increased with the association of drugs regardless of which antiangiogenic drug was used.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.