Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab

Donald R Nixon, Nicholas AP Flinn Trimed Eye Center, Barrie, ON, Canada Purpose: This study aims to investigate changes in contrast sensitivity (CS), visual acuity (VA), central retinal thickness (CRT), and vision-related quality of life in subjects with recalcitrant diabetic macular edema switche...

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Autores principales:	Nixon DR, Flinn NAP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	aflibercept ranibizumab diabetic macular edema contrast sensitivity visual acuity anti-VEGF Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/6f73f4244d974fd7935020e82ade442d
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spelling	oai:doaj.org-article:6f73f4244d974fd7935020e82ade442d2021-12-02T03:10:41ZEvaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab1177-5483https://doaj.org/article/6f73f4244d974fd7935020e82ade442d2018-01-01T00:00:00Zhttps://www.dovepress.com/evalation-of-contrast-sensitivity-and-other-visual-function-outco-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Donald R Nixon, Nicholas AP Flinn Trimed Eye Center, Barrie, ON, Canada Purpose: This study aims to investigate changes in contrast sensitivity (CS), visual acuity (VA), central retinal thickness (CRT), and vision-related quality of life in subjects with recalcitrant diabetic macular edema switched from long-term ranibizumab treatment to aflibercept.Patients and methods: In this prospective, investigator-masked, single-center study, 40 patients with persistent fluid, despite previous ranibizumab treatment, were switched to aflibercept with 5 consecutive monthly doses. The primary outcome was mean change from baseline to week 20 in Pelli–Robson CS. Secondary outcomes were mean change from baseline in best-corrected VA (BCVA), CRT, and National Eye Institute 25-Item Visual Function Questionnaire score.Results: Fifty eyes (baseline VA >6/30) were evaluated. A median of 21.1±11.9 (range 5–55) ranibizumab injections were administered prior to initiation of aflibercept. Mean CS improved from 1.40±0.14 log units at baseline to 1.46±0.15 log units at week 20 (P<0.001). VA improved with mean logarithm of the minimum angle of resolution BCVA of 0.33±0.19 at baseline compared with logarithm of the minimum angle of resolution BCVA of 0.28±0.16 at week 20 (P=0.0016). Mean CRT decreased from 324±85 to 289±61 µm (P<0.001). Twenty-two (55%) patients experienced an overall improvement in National Eye Institute 25-Item Visual Function Questionnaire score. Interestingly, an association was found between changes in CS and change in CRT (r2=0.385, P<0.001) and between changes in BCVA and change in CRT (r2=0.092, P=0.032).Conclusion: Switching from ranibizumab to aflibercept in patients with recalcitrant diabetic macular edema resulted in an improvement in all measured metrics, including CS, VA, and CRT. A majority of patients also indicated an improvement in vision-related quality of life. The finding of a stronger relationship between changes in CRT and CS compared with changes in CRT and BCVA suggests that the inclusion of CS as an endpoint may yield a more complete understanding of visual outcomes than that obtained by using VA alone. Keywords: aflibercept, ranibizumab, diabetic macular edema, contrast sensitivity, visual acuity, anti-VEGFNixon DRFlinn NAPDove Medical Pressarticleafliberceptranibizumabdiabetic macular edemacontrast sensitivityvisual acuityanti-VEGFOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 191-197 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	aflibercept ranibizumab diabetic macular edema contrast sensitivity visual acuity anti-VEGF Ophthalmology RE1-994
spellingShingle	aflibercept ranibizumab diabetic macular edema contrast sensitivity visual acuity anti-VEGF Ophthalmology RE1-994 Nixon DR Flinn NAP Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab
description	Donald R Nixon, Nicholas AP Flinn Trimed Eye Center, Barrie, ON, Canada Purpose: This study aims to investigate changes in contrast sensitivity (CS), visual acuity (VA), central retinal thickness (CRT), and vision-related quality of life in subjects with recalcitrant diabetic macular edema switched from long-term ranibizumab treatment to aflibercept.Patients and methods: In this prospective, investigator-masked, single-center study, 40 patients with persistent fluid, despite previous ranibizumab treatment, were switched to aflibercept with 5 consecutive monthly doses. The primary outcome was mean change from baseline to week 20 in Pelli–Robson CS. Secondary outcomes were mean change from baseline in best-corrected VA (BCVA), CRT, and National Eye Institute 25-Item Visual Function Questionnaire score.Results: Fifty eyes (baseline VA >6/30) were evaluated. A median of 21.1±11.9 (range 5–55) ranibizumab injections were administered prior to initiation of aflibercept. Mean CS improved from 1.40±0.14 log units at baseline to 1.46±0.15 log units at week 20 (P<0.001). VA improved with mean logarithm of the minimum angle of resolution BCVA of 0.33±0.19 at baseline compared with logarithm of the minimum angle of resolution BCVA of 0.28±0.16 at week 20 (P=0.0016). Mean CRT decreased from 324±85 to 289±61 µm (P<0.001). Twenty-two (55%) patients experienced an overall improvement in National Eye Institute 25-Item Visual Function Questionnaire score. Interestingly, an association was found between changes in CS and change in CRT (r2=0.385, P<0.001) and between changes in BCVA and change in CRT (r2=0.092, P=0.032).Conclusion: Switching from ranibizumab to aflibercept in patients with recalcitrant diabetic macular edema resulted in an improvement in all measured metrics, including CS, VA, and CRT. A majority of patients also indicated an improvement in vision-related quality of life. The finding of a stronger relationship between changes in CRT and CS compared with changes in CRT and BCVA suggests that the inclusion of CS as an endpoint may yield a more complete understanding of visual outcomes than that obtained by using VA alone. Keywords: aflibercept, ranibizumab, diabetic macular edema, contrast sensitivity, visual acuity, anti-VEGF
format	article
author	Nixon DR Flinn NAP
author_facet	Nixon DR Flinn NAP
author_sort	Nixon DR
title	Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab
title_short	Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab
title_full	Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab
title_fullStr	Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab
title_full_unstemmed	Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab
title_sort	evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/6f73f4244d974fd7935020e82ade442d
work_keys_str_mv	AT nixondr evaluationofcontrastsensitivityandothervisualfunctionoutcomesindiabeticmacularedemapatientsfollowingtreatmentswitchtoafliberceptfromranibizumab AT flinnnap evaluationofcontrastsensitivityandothervisualfunctionoutcomesindiabeticmacularedemapatientsfollowingtreatmentswitchtoafliberceptfromranibizumab
_version_	1718401923561816064

Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab

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