Abstract
Purpose :
To assess the impact of baseline CRT on clinical outcomes following treatment with aflibercept 8 mg versus 2 mg in patients with DME.
Methods :
In the randomized, double-masked, 96-week, non-inferiority PHOTON trial, patients with DME received aflibercept 8 mg every 12 or 16 weeks after 3 initial monthly doses (8q12 [n=328] or 8q16 [n=163]) or aflibercept 2 mg every 8 weeks after 5 monthly doses (2q8 [n=167]). This post-hoc analysis evaluated the effect of 8q12 and 8q16 versus 2q8 on best-corrected visual acuity (BCVA) and CRT through Week 48 by baseline CRT quartiles (Q1: ≤360 µm; Q2: >360–≤430 µm; Q3: >430–≤528 µm; Q4: >528 µm).
Results :
At baseline, there were general trends of decreasing mean BCVA and increasing mean CRT across quartiles (Table). At Week 48, mean BCVA was generally comparable across treatment groups in Q1 to Q3. In Q4, eyes in the 8q16 group had lower mean BCVA at baseline and Week 48 versus 8q12 and 2q8. Mean CRT at Week 48 was comparable across treatment groups in Q1 to Q3, with slightly higher mean CRT values in Q4. When examining Q4 in detail, mean CRT increase 8 weeks following the last initial monthly dose (third dose for 8q12 and 8q16 and fifth dose for 2q8) was +4 µm in 8q12, +6 µm in 8q16, and +56 µm in 2q8, reflecting less fluid reaccumulation with aflibercept 8 mg.
Conclusions :
Across baseline CRT quartiles, aflibercept 8 mg resulted in meaningful improvements in BCVA and CRT at Week 48. In eyes with thickest CRT at baseline, fluid reaccumulation was numerically less 8 weeks after the last initial monthly dose with aflibercept 8 mg versus 2 mg, suggesting a more durable treatment effect.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.