Predictors of Functional and Anatomic Outcomes in Patients with Diabetic Macular Edema Treated with Ranibizumab

Sophie, Raafay; Lu, Na; Campochiaro, Peter A.

doi:10.1016/j.ophtha.2015.02.036

Cited by 206 publications

(204 citation statements)

References 11 publications

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“…Some studies found worse outcomes or no difference [15-17], whereas others support the finding in this study that better visual acuity gain is associated with the presence of subretinal fluid at baseline [18, 19]. …”

Section: Discussionsupporting

confidence: 72%

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

et al. 2019

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Purpose: To evaluate real-life outcomes in treatment-naive patients with diabetic macular edema (DME) treated with anti-vascular endothelial growth factor (VEGF) agents using a treat-and-extend regimen without a fixed loading phase. Methods: Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) measured using optical coherence tomography at baseline and after 1 year of treatment, intervals and number of injections were analyzed. Subgroup analysis was performed to compare anatomical and functional outcomes between patients receiving ranibizumab or aflibercept. Results: Seventy-five eyes of 61 patients met the inclusion criteria and had follow-up for 1 year. Baseline BCVA and CRT were 68.1 ± 13.2 letters and 424 ± 135 µm, retrospectively. After 1 year, there was a significant mean gain in BCVA of +5.8 ± 7.4 letters (paired t test: p < 0.0001) and a significant decrease in mean CRT of –117 ± 134 µm (paired t test: p < 0.0001). The mean number of anti-VEGF injections was 10.0 ± 1.6 (range 6–12). The mean maximum interval between injections was 8.5 ± 2.9 weeks (range 4–14) and the mean interval 6.0 ± 1.2 weeks (range 4.1–8.9). 96% of eyes could be extended after a mean of 5.3 injections and 17% of patients could be extended before reaching a formal loading dose of 3 injections. Subgroup analysis did not reveal any differences in outcomes between patients treated with ranibizumab or aflibercept. Subretinal fluid at baseline was associated with better BCVA gain after 1 year (stepwise forward regression analysis, p = 0.003). Conclusion: Our results suggest that not all patients with DME require a fixed loading phase when initiating anti-VEGF treatment. Finding anatomical predictors to identify this subgroup of patients would help to reduce treatment burden and optimize clinical outcomes.

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Section: Discussionsupporting

confidence: 72%

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

et al. 2019

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“…Since the low visual gains achieved by the 2q8 group were already evident at 4 weeks, the higher proportion of patients with a history of proliferative diabetic retinopathy, possibly indicating greater ischemia, might have accounted for the observed difference in BCVA outcome for this group. This observation was later supported by a post-hoc analysis of RISE and RIDE studies that showed that the severity of diabetic retinopathy negatively affects the response to ranibizumab injections [17] . The low visual gains achieved by the 0.5q4 group were attributed to the low efficacy of the 0.5 mg dose.…”

Section: The Davinci Studymentioning

confidence: 83%

Intravitreal Aflibercept in Diabetic Macular Edema: Long-Term Outcomes

Introini¹,

Casalino²

2017

Management of Diabetic Retinopathy

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For decades, macular laser photocoagulation has been the standard of care in the treatment of diabetic macular edema (DME). With the relatively recent advent of anti-vascular endothelial growth factor (VEGF) agents, DME treatment has entered a new era. VEGF is a well-known pro-angiogenic and pro-permeability factor involved in the pathogenesis of DME. VEGF blockade has proven remarkably effective at reducing DME and improving visual acuity (VA) in eyes with center involved DME causing VA loss in several randomized controlled trials (RCTs). Intravitreal aflibercept, ranibizumab, and bevacizumab (the latter used off-label) are 3 anti-VEGF molecules currently available for DME treatment. Aflibercerpt is a 115-kDA recombinant fusion protein consisting of VEGF binding domains of human VEGF receptors-1 and -2 fused to the Fc domain of human immunoglobulin-G1. The ability to bind placental growth factors 1 and 2 (which is another pro-permeability mediator) and a theoretically long half-life are potential advantages of aflibercept over other anti-VEGF agents. The use of intravitreal aflibercept in DME treatment has been investigated in several RCTs. The aim of this chapter is to briefly report on the current evidence for treating DME with intravitreal aflibercept.

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“…Bu durum tedavi başarısını etkileyen başka faktörlerin de olduğunu düşündürmektedir. Şu anki literatürde bu durumu araştıran yayın sayısı çok azdır (12)(13)(14) .…”

Section: Gereç Ve Yöntemunclassified

“…DRCR.net, RISE ve RIDE gibi daha önceki çalışmalar da bu bulguyu destekler niteliktedir (12,13,15,16) . Bu durum "ceiling effect" (Tavan etkisi) denilen durumla açıklanabilir.…”

Section: Gereç Ve Yöntemunclassified

The Effect Of Presence Of Hard Exudates On Visual And Anatomical Outcomes In Diabetic Macular Edema

Bayat¹,

Çakir²,

Bölükbaşı³

et al. 2018

Okmeydani Medical Journal

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Amaç: Diyabetik maküler ödemde (DMÖ) sert eksuda varlığının anti-vasküler endotelyal büyüme faktörü (VEBF) tedavisinde prognoza olan etkisini araştırmak. Gereç ve CMT improvement (p=0.000,p=0.016 and p=0.214 respectively). Conclusion:Although the presence of exudates was found to be a negative predictor for visual outcomes, it did not have any effects on anatomical outcomes in patients with DME under anti-VEGF treatment.

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Predictors of Functional and Anatomic Outcomes in Patients with Diabetic Macular Edema Treated with Ranibizumab

Cited by 206 publications

References 11 publications

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

Intravitreal Aflibercept in Diabetic Macular Edema: Long-Term Outcomes

The Effect Of Presence Of Hard Exudates On Visual And Anatomical Outcomes In Diabetic Macular Edema

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