July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Real-world outcomes in patients with macular oedema secondary to central retinal vein occlusion receiving intravitreal anti-VEGF therapy in a UK public hospital setting
Author Affiliations & Notes
  • Sarah Ah-Moye
    Royal Free London NHS Foundation Trust, London, United Kingdom
  • Pardis Zalmay
    Royal Free London NHS Foundation Trust, London, United Kingdom
  • Magnus Theodorsson
    Royal Free London NHS Foundation Trust, London, United Kingdom
  • Martin Lynn Harris
    Royal Free London NHS Foundation Trust, London, United Kingdom
  • Riaz Asaria
    Royal Free London NHS Foundation Trust, London, United Kingdom
  • Adrian Hunt
    Macular Research Group, Save Sight Institute, Sydney University and Sydney Eye Hospital, Sydney, New South Wales, Australia
  • Daniel Barthelmes
    Macular Research Group, Save Sight Institute, Sydney University and Sydney Eye Hospital, Sydney, New South Wales, Australia
    University of Zurich, Switzerland
  • Mark C Gillies
    Macular Research Group, Save Sight Institute, Sydney University and Sydney Eye Hospital, Sydney, New South Wales, Australia
  • Vuong Nguyen
    Macular Research Group, Save Sight Institute, Sydney University and Sydney Eye Hospital, Sydney, New South Wales, Australia
  • Hemal Mehta
    Royal Free London NHS Foundation Trust, London, United Kingdom
    Macular Research Group, Save Sight Institute, Sydney University and Sydney Eye Hospital, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Sarah Ah-Moye, None; Pardis Zalmay, None; Magnus Theodorsson, None; Martin Harris, Allergan (R), Bayer (R), Novartis (R); Riaz Asaria, Allergan (R), Bayer (R), Novartis (R); Adrian Hunt, None; Daniel Barthelmes, Bayer (R), Bayer (C), Novartis (R), Novartis (C); Mark Gillies, Allergan (R), Allergan (C), Bayer (C), Bayer (R), Novartis (R), Novartis (C), Roche (C), Roche (R); Vuong Nguyen, None; Hemal Mehta, Allergan (R), Allergan (C), Bayer (C), Bayer (R), Heidelberg Engineering (R), Novartis (R), Novartis (C), Roche (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4061. doi:
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      Sarah Ah-Moye, Pardis Zalmay, Magnus Theodorsson, Martin Lynn Harris, Riaz Asaria, Adrian Hunt, Daniel Barthelmes, Mark C Gillies, Vuong Nguyen, Hemal Mehta; Real-world outcomes in patients with macular oedema secondary to central retinal vein occlusion receiving intravitreal anti-VEGF therapy in a UK public hospital setting. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4061.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess real-world outcomes of intravitreal anti-VEGF therapy for macular oedema secondary to central retinal vein occlusion in a UK public hospital setting.

Methods : We performed a prospective, observational study of all treatment naïve patients receiving intravitreal aflibercept or ranibizumab monotherapy for macula oedema secondary to central retinal vein occlusion (CRVO) at the Royal Free London NHS Foundation Trust (RFLNFT). Fight Retinal Blindness! software was used to record real-world outcomes including visual acuity (VA), central subfield thickness (CST) at baseline and 12 months as well as adverse events (AEs) and number of injections over 12 months. A sensitivity analysis excluded eyes that had vitreoretinal surgery or cataract surgery during the observation period. P-values were obtained using paired t-tests.

Results : There were 28 eyes from 28 patients completing 12 months of monotherapy for CRVO. At 12 months, the mean (SD) VA improved from 40.3(19.4) to 49.8 (25.2) letters, an improvement of 9.5 letters (95%CI: 1.5, 17.5; p=0.024). Mean (SD) CST reduced from 573 (115) to 290 (148) µm, a reduction of 283µm (95%CI: -359, -207; p<0.001). There was a median (Q1, Q3) of 6 (5, 7) injections administered over 12 months. There were 2 eyes that experienced anterior segment neovascularization.
The 15 eyes on aflibercept monotherapy gained a mean of 13 (95%CI: 2.6, 23.4; baseline VA: 41.9) letters and CST changed by -324µm (95%CI: -430, -218; baseline CST: 577) after a median (Q1, Q3) of 6 (5, 7.5) injections at 12 months.
The 13 eyes on ranibizumab monotherapy gained a mean of 5.5 (95%CI: -8.2, 19.3; baseline VA: 38.4) letters and CST changed by -243µm (95%CI: -363, -122; baseline CST: 570) after a median (Q1, Q3) of 5 (5, 7) injections at 12 months. These real-world results were compared with the GALILEO (aflibercept for CRVO) and CRYSTAL (ranibizumab for CRVO) randomized clinical trials (Table 1).

Conclusions : Patients receiving intravitreal anti-VEGF therapy in a real-world setting can achieve good VA and anatomical outcomes. However, the size of the benefit was less than in randomized clinical trials, likely related to reduced injection frequency.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Table 1: Comparison of 12 month outcomes of intravitreal aflibercept or ranibizumab therapy for CRVO in the real world versus randomized clinical trials

Table 1: Comparison of 12 month outcomes of intravitreal aflibercept or ranibizumab therapy for CRVO in the real world versus randomized clinical trials

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