Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab

Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab

Laurence S Lim,1,2 Wei Yan Ng,2 Ranjana Mathur,2 Doric Wong,2 Edmund YM Wong,2 Ian Yeo,2 Chui Ming Gemmy Cheung,2 Shu Yen Lee,2 Tien Yin Wong,2 Thanos D Papakostas,1 Leo A Kim1 1Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; 2Vitreoretinal Department,...

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Autores principales: Lim LS, Ng WY, Mathur R, Wong D, Wong EY, Yeo I, Cheung CM, Lee SY, Wong TY, Papakostas TD, Kim LA
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2015
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Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/42fdbbd441554552bf18a71e88ed8ae8
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spelling oai:doaj.org-article:42fdbbd441554552bf18a71e88ed8ae82021-12-02T01:27:56ZConversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab1177-5483https://doaj.org/article/42fdbbd441554552bf18a71e88ed8ae82015-09-01T00:00:00Zhttps://www.dovepress.com/conversion-to-aflibercept-for-diabeticnbspmacular-edema-unresponsive-t-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Laurence S Lim,1,2 Wei Yan Ng,2 Ranjana Mathur,2 Doric Wong,2 Edmund YM Wong,2 Ian Yeo,2 Chui Ming Gemmy Cheung,2 Shu Yen Lee,2 Tien Yin Wong,2 Thanos D Papakostas,1 Leo A Kim1 1Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; 2Vitreoretinal Department, Singapore National Eye Centre, Singapore Background: The purpose of this study was to determine if eyes with diabetic macular edema (DME) unresponsive to ranibizumab or bevacizumab would benefit from conversion to aflibercept.Methods: This study was conducted as a retrospective chart review of subjects with DME unresponsive to ranibizumab and/or bevacizumab and subsequently converted to aflibercept.Results: In total, 21 eyes from 19 subjects of mean age 62±15 years were included. The majority of subjects were male (63%). The median number of ranibizumab or bevacizumab injections before switching to aflibercept was six, and the median number of aflibercept injections after switching was three. Median follow-up was 5 months after the switch. Mean central foveal thickness (CFT) was 453.52±143.39 mm immediately prior to the switch. Morphologically, intraretinal cysts were present in all cases. Mean CFT after the first injection decreased significantly to 362.57±92.82 mm (Wilcoxon signed-rank test; P<0.001). At the end of follow-up, the mean CFT was 324.17±98.76 mm (P<0.001). Mean visual acuity was 0.42±0.23 logMAR just prior to the switch, 0.39±0.31 logMAR after one aflibercept injection, and 0.37±0.22 logMAR at the end of follow-up. The final visual acuity was significantly better than visual acuity before the switch (P=0.04).Conclusion: Eyes with DME unresponsive to multiple ranibizumab/bevacizumab injections demonstrate anatomical and visual improvement on conversion to aflibercept. Keywords: diabetic retinopathy, macular edema, aflibercept, bevacizumab, ranibizumabLim LSNg WYMathur RWong DWong EYYeo ICheung CMLee SYWong TYPapakostas TDKim LADove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 1715-1718 (2015)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Lim LS
Ng WY
Mathur R
Wong D
Wong EY
Yeo I
Cheung CM
Lee SY
Wong TY
Papakostas TD
Kim LA
Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab
description Laurence S Lim,1,2 Wei Yan Ng,2 Ranjana Mathur,2 Doric Wong,2 Edmund YM Wong,2 Ian Yeo,2 Chui Ming Gemmy Cheung,2 Shu Yen Lee,2 Tien Yin Wong,2 Thanos D Papakostas,1 Leo A Kim1 1Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA; 2Vitreoretinal Department, Singapore National Eye Centre, Singapore Background: The purpose of this study was to determine if eyes with diabetic macular edema (DME) unresponsive to ranibizumab or bevacizumab would benefit from conversion to aflibercept.Methods: This study was conducted as a retrospective chart review of subjects with DME unresponsive to ranibizumab and/or bevacizumab and subsequently converted to aflibercept.Results: In total, 21 eyes from 19 subjects of mean age 62±15 years were included. The majority of subjects were male (63%). The median number of ranibizumab or bevacizumab injections before switching to aflibercept was six, and the median number of aflibercept injections after switching was three. Median follow-up was 5 months after the switch. Mean central foveal thickness (CFT) was 453.52±143.39 mm immediately prior to the switch. Morphologically, intraretinal cysts were present in all cases. Mean CFT after the first injection decreased significantly to 362.57±92.82 mm (Wilcoxon signed-rank test; P<0.001). At the end of follow-up, the mean CFT was 324.17±98.76 mm (P<0.001). Mean visual acuity was 0.42±0.23 logMAR just prior to the switch, 0.39±0.31 logMAR after one aflibercept injection, and 0.37±0.22 logMAR at the end of follow-up. The final visual acuity was significantly better than visual acuity before the switch (P=0.04).Conclusion: Eyes with DME unresponsive to multiple ranibizumab/bevacizumab injections demonstrate anatomical and visual improvement on conversion to aflibercept. Keywords: diabetic retinopathy, macular edema, aflibercept, bevacizumab, ranibizumab
format article
author Lim LS
Ng WY
Mathur R
Wong D
Wong EY
Yeo I
Cheung CM
Lee SY
Wong TY
Papakostas TD
Kim LA
author_facet Lim LS
Ng WY
Mathur R
Wong D
Wong EY
Yeo I
Cheung CM
Lee SY
Wong TY
Papakostas TD
Kim LA
author_sort Lim LS
title Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab
title_short Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab
title_full Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab
title_fullStr Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab
title_full_unstemmed Conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab
title_sort conversion to aflibercept for diabetic macular edema unresponsive to ranibizumab or bevacizumab
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/42fdbbd441554552bf18a71e88ed8ae8
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