Liran Tiosano1, Rita Ehrlich2,3, Yoreh Barak4, Haya Katz5, Russell Pokroy6, Tarek Jaouni1, Jaime Levy1, Joel Hanhart7, Ori Segal3,8, Shiri Shulman3,9, Michaella Goldstein3,9, Itay Chowers10. 1. Department of Ophthalmology, Hadassah-Hebrew University Medical Center, and the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel. 2. Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel. 3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Department of Ophthalmology, Rambam Medical Center, Haifa, Israel. 5. Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel. 6. Department of Ophthalmology, Assaf Harofeh Medical Center, Be'er Ya'akov, Israel. 7. Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel. 8. Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel. 9. Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel. 10. Department of Ophthalmology, Hadassah-Hebrew University Medical Center, and the Hebrew University - Hadassah School of Medicine, Jerusalem, Israel. chowers@hadassah.org.il.
Abstract
PURPOSE: To evaluate the efficacy of intravitreal aflibercept as a second-line therapy in eyes with persistent diabetic macular oedema (DMO) despite receiving initial bevacizumab treatment. METHODS: A prospective multicentre study was conducted in nine academic clinics in Israel. Starting from the first follow-up visit, a treat-and-extend regimen was applied in which the treatment intervals were extended by 2 weeks based on macular thickness using SD-OCT. The primary outcome was central subfield thickness (CST) at week 52. RESULTS: Forty-four patients (n = 48 eyes) were recruited to the study, and 43 eyes completed 52 weeks of follow-up. Patients received a mean (±SD) of 7.9 ± 3.5 bevacizumab injections before enrolment. The mean (±SD) CST under aflibercept therapy decreased from 468 ± 131 μm at baseline to 303 ± 67 μm at 52 weeks (p = 0.002), and best corrected visual acuity improved from 64 ± 15 ETDRS letters at baseline to 75 ± 8 letters at week 52 (p = 0.001). Twenty (46%) eyes met the treat-and-extend criteria and received a mean (±SD) of 10.9 ± 2 aflibercept injections. CONCLUSIONS: Eyes with persistent DMO following initial bevacizumab therapy had a marked reduction in macular thickness and improved visual acuity following 1 year of treatment with intravitreal aflibercept. Less than half of the patients met eligibility criteria for extension of the treatment interval; for these patients, the treat-and-extend regimen resulted in a maximum treatment interval of 10 weeks during the first year.
PURPOSE: To evaluate the efficacy of intravitreal aflibercept as a second-line therapy in eyes with persistent diabetic macular oedema (DMO) despite receiving initial bevacizumab treatment. METHODS: A prospective multicentre study was conducted in nine academic clinics in Israel. Starting from the first follow-up visit, a treat-and-extend regimen was applied in which the treatment intervals were extended by 2 weeks based on macular thickness using SD-OCT. The primary outcome was central subfield thickness (CST) at week 52. RESULTS: Forty-four patients (n = 48 eyes) were recruited to the study, and 43 eyes completed 52 weeks of follow-up. Patients received a mean (±SD) of 7.9 ± 3.5 bevacizumab injections before enrolment. The mean (±SD) CST under aflibercept therapy decreased from 468 ± 131 μm at baseline to 303 ± 67 μm at 52 weeks (p = 0.002), and best corrected visual acuity improved from 64 ± 15 ETDRS letters at baseline to 75 ± 8 letters at week 52 (p = 0.001). Twenty (46%) eyes met the treat-and-extend criteria and received a mean (±SD) of 10.9 ± 2 aflibercept injections. CONCLUSIONS: Eyes with persistent DMO following initial bevacizumab therapy had a marked reduction in macular thickness and improved visual acuity following 1 year of treatment with intravitreal aflibercept. Less than half of the patients met eligibility criteria for extension of the treatment interval; for these patients, the treat-and-extend regimen resulted in a maximum treatment interval of 10 weeks during the first year.
Authors: John F Payne; Charles C Wykoff; W Lloyd Clark; Beau B Bruce; David S Boyer; David M Brown Journal: Ophthalmology Date: 2016-11-08 Impact factor: 12.079
Authors: Diana V Do; Quan Dong Nguyen; Robert Vitti; Alyson J Berliner; Andrea Gibson; Namrata Saroj; Yuhwen Soo; David S Boyer Journal: Ophthalmology Date: 2016-01-28 Impact factor: 12.079