First Author: M.Lukic UK
Co Author(s): Z. Shalchi M. Westcott R. Hamilton D. Sim A. Bruynseels R. Rajendram
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To compare optical coherence tomography (OCT)-derived anatomical, and visual outcomes of treatment-naïve patients and those who were switched from ranibizumab to aflibercept.
Retrospective, real-life, case-comparison study of patients with diabetic macular oedema. Moorfields Eye Hospital, London, UK
162 patients; 198 eyes with diabetic macular oedema (DMO) were included. All patients were followed up for 5 months after the first injection of aflibercept was given. Parameters measure included visual acuity (VA), OCT-derived central foveal thickness (CFT), and macular volume (MV) at baseline and month 5. Anatomical and visual outcomes by injections received (4 or less than 4 aflibercept injections) and anti-VEGF agent washout period (greater or less than 3 months) were compared. The percentage of those who achieved vision gain ≥ 15 letters and decrease of CFT ≥ 100 µm in both groups was compared. The two-tailed paired t-test was used for statistical analysis.
Ninety-six eyes had previous ranibizumab injections and 102 eyes were treatment naïve. Each patient received maximum 4 injections over the study period. At baseline, in the treatment naïve (TN) group the mean VA (SD) was 62.6 (15.1) ETDRS letters, CFT was 431.8 (127.1) µm and MV was 9.53 (1.76) mm3 whilst in the switched (SW) group the mean VA (SD) was 63.3 (15.9) ETDRS letters, CFT was 433 (167) µm and MV was 10.15 (2.62) mm3. The mean change in VA, CFT and MV in TN group was + 4.07 ETDRS (p < 0.0001) , -143.72 μm (p < 0.0001), -1,04 mm3 (p < 0.0001) and in SW group it was +3,33 ETDRS letters (p = 0.0024) , – 142,56 μm (p < 0.0001) and – 1,75 mm3 (p < 0.0001). Eleven (10.78%) TN eyes and 8 (8.33%) SW eyes gained ≥ 15 ETDRS letters at month 5. Fifty eight (56.86%) TN eyes and 52 (54.16%) SW eyes had a decrease in CFT of ≥ 100 microns.
There was a significant gain in VA in both switched and treatment naïve groups at 5 months after commencing treatment with aflibercept for DMO, which suggests early benefit to both groups of patients. There was a statstical significant change in VA, CFT and VA in both groups at 5 months after baseline. A similar proportion of eyes in each group achieved VA gain ≥ 15 ETDRS letters and a similar proportion of eyes in each group had a decrease in CFT of ≥ 100 microns at month 5.