Comparative efficacy of bevacizumab, ranibizumab, and aflibercept for treatment of macular edema secondary to retinal vein occlusion: a systematic review and network meta-analysis

Sangroongruangsri, Sermsiri; Ratanapakorn, Tanapat; Wu, Olívia; Anothaisintawee, Thunyarat; Chaikledkaew, Usa

doi:10.1080/17512433.2018.1507735

Cited by 68 publications

(53 citation statements)

References 48 publications

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“…Possible reasons for the significant anatomical and functional response seen with aflibercept may be due to its differing pharmacokinetic and pharmacodynamics properties and the greater disease activity in these patients . Aflibercept features a higher binding affinity to VEGF‐A and to additional growth factors released during angiogenesis such as VEGF‐B and PIGF, in contrast to inactivation of only VEGF‐A with bevacizumab and ranibizumab . These patients also had a lower baseline BCVA, therefore also having a higher ceiling effect and more room for gains in BCVA to be seen.…”

Section: Discussionmentioning

confidence: 99%

Prospective study of aflibercept for the treatment of persistent macular oedema secondary to retinal vein occlusions in eyes not responsive to long‐term treatment with bevacizumab or ranibizumab

Spooner

Fraser‐Bell

Hong³

et al. 2019

Clinical Exper Ophthalmology

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Importance: To examine the effect of switching from intravitreal bevacizumab or ranibizumab to aflibercept in eyes with persistent macular oedema due to retinal vein occlusion (RVO). Background: We report the results of a prospective interventional study on the effect of aflibercept 2 mg in eyes with persistent macular oedema after long-term treatment with bevacizumab or ranibizumab. Design: Non-randomized, prospective clinical trial. Participants: Eighteen eyes of eighteen patients were included.Methods: Eyes with persistent macular oedema despite a minimum of four previous intravitreal bevacizumab/ranibizumab injections were recruited into this 48-week trial. Three loading doses of intravitreal aflibercept were administered every 4-weeks, thereafter every 8-weeks until week 48. Main Outcome Measures: Mean change from baseline in best corrected visual acuity (BCVA) as measured by early treatment diabetic retinopathy score (ETDRS) and central macular thickness (CMT) as measured by spectral domain optical coherence tomography (SD-OCT) at 48 weeks. Results: Patients had received a mean of 40.0 ± 17.8 bevacizumab/ranibizumab intravitreal injections prior to switching to aflibercept. The mean number of previous injections administered in the 12-months preceding entry into the study was 10.2 ± 2.4. Mean vision change at week 48 was +21.1 ± 5.1 ETDRS letters in the BRVO group and +18.8 ± 5.9 letters at in the CRVO group (P < .001 for both groups). Mean decrease in CMT was 87.6 ± 48.8 μm and 191.0 ± 128.3 μm, in the BRVO and CRVO groups, respectively (P < .001). Using linear regression

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Section: Discussionmentioning

confidence: 99%

Prospective study of aflibercept for the treatment of persistent macular oedema secondary to retinal vein occlusions in eyes not responsive to long‐term treatment with bevacizumab or ranibizumab

Spooner

Fraser‐Bell

Hong³

et al. 2019

Clinical Exper Ophthalmology

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“…If elevated IOP occurred, IOP was measured twice a day until the IOP was controlled. The ghost cell glaucoma was defined as the presence of both high IOP and ghost cells in the anterior chambe r [12]. Follow-up visits were scheduled at 1,2,7,14 and 30 days after the initial surgery.…”

Section: Methodsmentioning

confidence: 99%

“…At present, IV of anti-VEGF agents has also been proved to be safe and effective in the treatment of agerelated macular degeneration [11], cystoid macular edema due to retinal vein occlusion [12] in large clinical trials. The sustained intraocular pressure elevation was reported to be related to the total number of injections, a greater frequency of injection, and pre-existing glaucoma [13].…”

Section: Introductionmentioning

confidence: 99%

“…The sustained intraocular pressure elevation was reported to be related to the total number of injections, a greater frequency of injection, and pre-existing glaucoma [13]. The occurrence of ghost cell glaucoma after IV was rarely reported in patients with either age-related macular degeneration or retinal vein occlusion who need IV [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Ghost cell glaucoma after intravitreous injection of ranibizumab in proliferative diabetic retinopathy

Zhao

et al. 2020

BMC Ophthalmol

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Background: The development of ghost cell glaucoma in patients with proliferative diabetic retinopathy (PDR) after intravitreous injection (IV) was rare. Here we reported a series of patients with PDR who received Intravitreous Ranibizumab (IVR) and developed ghost cell glaucoma and analyzed the potential factors that might be related to the development of ghost cell glaucoma. Methods: Retrospective case series study. The medical records of 71 consecutive eyes of 68 PDR patients who were reviewed. The development of ghost cell glaucoma after IVR was recorded. Characteristics of enrolled patients were retrieved from their medical charts. Factors associated with ghost cell glaucoma were compared between eyes with the development of ghost cell glaucoma and eyes without the development of ghost cell glaucoma. Variables were further enrolled in a binary backward stepwise logistic regression model, and the model that had the lowest AIC was chosen.Results: There were 8 out of 71 eyes of the PDR patients developed ghost cell glaucoma after they received IVR. The interval between detection of elevation of intraocular pressure (IOP) and IV ranged from 0 to 2 days. Among them, after IVR, there were two eyes had IOP greater than 30 mmHg within 30 min, four eyes showed normal IOP at 30 min, and then developed ghost cell glaucoma within 1 day, two eyes developed ghost cell glaucoma between 24 and 48 h. The mean IOP was 46.5 ± 8.0 mmHg. All patients gained normal IOP after vitrectomy without medicine for lowering IOP. The presence of ghost cell glaucoma was associated with tractional retinal detachment (RR = 4.60 [2.02~8.48], p = 0.004) and fibrovascular membrane involving disk (RR = -3.57 [− 7.59~− 0.92], p = 0.03) (AIC = 39.23, AUC = 0.88) in a logistic regression model. Conclusion: Attention to postoperative IOP should be paid to patients with PDR undergoing vitrectomy who receive a preoperative IV of anti-VEGF agents. PDR patients with tractional retinal detachment or fibrovasucular membrane involving optic disc are more likely to develop ghost cell glaucoma after IV.

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“…Sangroongruangsri S et al could not identify the significant difference in BCVA improvement and CMT reduction among patients treated with Bevacizumab, ranibizumab and aflibercept [18]. The BRAVO trial assessed the efficacy of ranibizumab in patients with BRVO and found a significant improvement in visual acuity and a reduction in central foveal thickness in the ranibizumab-treated group compared to a sham group [16].…”

Section: Original Research Articlementioning

confidence: 99%

Comparison of ranibizumab and bevacizumab for macular edema associated with retinal vein occlusion

Sharma

Jat

Singh

et al. 2019

Trop J Ophthalmol Otolaryngol

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To assess the effectiveness of intravitreal ranibizumab compared with bevacizumab for the treatment of macular edema associated with retinal vein occlusion (RVO). Methods: This was a retrospective study of 64 eyes with macular edema associated with RVO. Patients received either 1.25 mg of intravitreal bevacizumab (n = 32) or 0.5 mg of intravitreal ranibizumab (n = 32). Visual acuity, clinical bio-microscopic examination and central macular thickness (CMT) by Optical Coherence Tomography (OCT) was assessed at 6 weeks post injection. The CMT before and six weeks after the injection as assessed by OCT were compared. Statistical analysis was performed using paired student t-test. The improvement in CMT was also compared between the two groups, statistical analysis was performed using un-paired student t-test. Results: The best-corrected visual acuity significantly improved from logarithm of the minimal angle of resolution (logMAR) 0.792 ±0.36 at baseline to 0.575 ± 0.34 at 6 weeks in the bevacizumab group (p =0.001) and from logMAR 0.851 ± 0.35 at baseline to 0.336 ± 0.20 at 6 weeks in the ranibizumab group (p = 0.001), which is statistically significant difference. The reduction in CMT was from 545.44 ± 176.43 μm at baseline to 378.34 ±95.13 at 6 weeks in the bevacizumab group (p = 0.001) and 524.25± 195.94 μm at baseline to 243±80.72 μm at 6 weeks in the ranibizumab group (p=0.001) which was also a statistically significant difference (p = 0.001). Conclusions: Both ranibizumab and bevacizumab were effective for the treatment of RVO. The visual outcome and reduction in macular thickness was better by ranibizumab at the earliest follow-up of 6 weeks.

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Comparative efficacy of bevacizumab, ranibizumab, and aflibercept for treatment of macular edema secondary to retinal vein occlusion: a systematic review and network meta-analysis

Cited by 68 publications

References 48 publications

Prospective study of aflibercept for the treatment of persistent macular oedema secondary to retinal vein occlusions in eyes not responsive to long‐term treatment with bevacizumab or ranibizumab

Prospective study of aflibercept for the treatment of persistent macular oedema secondary to retinal vein occlusions in eyes not responsive to long‐term treatment with bevacizumab or ranibizumab

Ghost cell glaucoma after intravitreous injection of ranibizumab in proliferative diabetic retinopathy

Comparison of ranibizumab and bevacizumab for macular edema associated with retinal vein occlusion

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