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Aflibercept therapy for diabetic macular edema resistant to bevacizumab and/or ranibizumab, our experience

Session Details

Session Title: Vascular Diseases and Diabetic Retinopathy II

Session Date/Time: Friday 18/09/2015 | 16:30-18:00

Paper Time: 16:30

Venue: Calliope

First Author: : B.Kambo ALBANIA

Co Author(s): :    M. Asani   K. Bardhi           

Abstract Details

PURPOSE:To evaluate the visual acuity and anatomic outcomes of intravitreal aflibercept 2.0 mg in cases of diabetic macular edema (DME) with persistent fluid on SD-OCT ( spectral domain optical coherence tomography ) despite regular intravitreal injections of bevacizumab 1.25 mg or ranibizumab 0.5 mg.

Setting:

Blerina Kambo , Minir Asani , Klajda Bardhi . German Eye Clinic , Tirana , Albania .

Methods:

In this case series 6 - 12 months fellow up , DME patients with persistent retinal fluid despite regular intravitreal therapy with bevacizumab 1.25 mg and/or ranibizumab 0.5 mg , (max. 3 of injection ) were switched to intravitreal aflibercept 2.0 mg. The data includes details of prior treatments, best available visual acuity, central subfield thickness(CST), and the area of thickest edema on registered SD-OCT before and after aflibercept intravitreal injection .

Results:

A total of 11 eyes with persistent DME were included. All eyes had persistent fluid after at least 3 monthly bevacizumab and/or ranibizumab intavitreal injection . At 1 month after the first aflibercept Injection , 73% (8 /11 eyes) showed anatomic improvement . 27% (3/11eyes) showed stable or worsening edema. On average, CST(central subfield thickness) decreased from 411 to 338 microns after one aflibercept injection . When measuring the thickest point in the macula on registered SD-OCT, the thickness decreased from 546 to 466 microns after one aflibercept injection . All eyes followed 3 or more aflibercept injections showed further improvement (3 eyes). Visual acuity improved in 3 of 8 eyes one month after the first aflibercept injection .

Conclusions:

A majority of DME cases with persistent fluid on SD-OCT despite regular bevacizumab 1.25 mg and/or ranibizumab 0.5 mg intravitreal injection showed a positive anatomic response to aflibercept 2.0 mg. and improvement in visual acuity in some cases. Intravitreal aflibercept appears to be anatomically beneficial in cases of DME with persistent fluid despite treatment with bevacizumab and/or ranibizumab.

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