Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab

• Published in: Eye (London) Vol. 30; no. 1; pp. 79 - 84
• Main Authors: Papakostas, T D, Lim, L, van Zyl, T, Miller, J B, Modjtahedi, B S, Andreoli, C M, Wu, D, Young, L H, Kim, I K, Vavvas, D G, Esmaili, D D, Husain, D, Eliott, D, Kim, L A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-01-2016; Nature Publishing Group
• Subjects: 692/308/409; 692/699; Aged; Aged, 80 and over; Angiogenesis Inhibitors - therapeutic use; Bevacizumab - therapeutic use; Clinical Study; Drug Substitution; Female; Humans; Intravitreal Injections; Laboratory Medicine; Macular Edema - drug therapy; Macular Edema - etiology; Male; Medicine; Medicine & Public Health; Ophthalmology; Pharmaceutical Sciences/Technology; Ranibizumab - therapeutic use; Receptors, Vascular Endothelial Growth Factor - therapeutic use; Recombinant Fusion Proteins - therapeutic use; Retinal Vein Occlusion - complications; Retinal Vein Occlusion - drug therapy; Retrospective Studies; Surgery; Surgical Oncology; Treatment Failure; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity - drug effects
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2015.175

Purpose
To report the visual and anatomic outcomes in eyes with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) that were switched from either intravitreal bevacizumab or ranibizumab to intravitreal aflibercept.
Methods
Two-center retrospective chart review. Eyes with MO secondary to CRVO that received a minimum of three intravitreal injections of bevacizumab or ranibizumab and were switched to intravitreal aflibercept for persistent or recurrent MO not responding to either bevacizumab and/or ranibizumab.
Results
In all 42 eyes of 42 patients were included in the study. The median visual acuity before the switch was 20/126, 1 month after the first injection of aflibercept 20/89 (
P
=0.0191), and at the end of the follow-up 20/100 (
P
=0.2724). The median CRT before the switch was 536 μm, 1 month after the first injection of aflibercept 293.5 μm (
P
=0.0038), and at the end of the follow-up 279 μm (
P
=0.0013 compared to before the switch). The median number of weeks between injections before the switch was 5.6 and after the switch was 7.6 (
P
<0.0001).
Conclusion
Converting eyes with refractory MO due to CRVO to aflibercept can result in stabilization of the vision, improved macular anatomy, and extension of the injection interval.