Prospective trial of treat-and-extend regimen with aflibercept for branch retinal vein occlusion: 1-year results of the PLATON trial

Park, Dong-Geun; Jeong, Woo Jin; Park, Jung Min; Kim, Jung‐Yeul; Ji, Yong‐Sok; Sagong, Min

doi:10.1007/s00417-021-05150-y

Cited by 11 publications

(14 citation statements)

References 22 publications

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“…Within aflibercept studies in BRVO, different re-treatment regimens without the application of laser photocoagulation have been evaluated (Treat and extend, treat and monitor), finding low re-treatment need with good functional and anatomical results (Pichi et al 2019;Arai et al 2020;Park et al 2021). Some studies even find just one loading dose, followed by as-needed treatment, enough to maintain good treatment outcomes (Pichi et al 2019;Sakanishi et al 2021).…”

Section: Discussionmentioning

confidence: 99%

Navigated laser and aflibercept versus aflibercept monotherapy in treatment‐naïve branch retinal vein occlusion: A 12‐month randomized trial

Frederiksen

Vestergaard

Pedersen

et al. 2022

Acta Ophthalmologica

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Purpose: Angiostatic agents have proven effective in the treatment of macular oedema in patients with branch retinal vein occlusion (BRVO). However, treatment is inconvenient and expensive, and novel treatment regimens are warranted. We aimed to evaluate if combination treatment of navigated central retinal laser and aflibercept lowered the treatment burden in these patients. Methods: Treatment-na€ ıve patients with BRVO and macular oedema were included at two centres and randomized 1:1 to three monthly injections of 2.0 mg aflibercept with (Group A) or without (Group B) navigated central laser, followed by aflibercept as needed from month 4 through 12. Re-treatment need was evaluated, and secondary endpoints included functional and anatomical outcomes and safety evaluated by retinal microperimetry. Results: We evaluated 41 eyes of 41 patients with a mean age of 69.6 years. Baseline median best-corrected visual acuity (BCVA) was 70.0 letters, and median central retinal thickness (CRT) was 502 lm with no difference between Groups A (n = 21) and B (n = 20). Percentage of patients needing re-treatment after month three was 71% and 80% (p = 0.72). At month 12, groups did not differ in number of injections after loading (1 versus 2, p = 0.43), change in BCVA (+12.8 versus +15.1 letters, p = 0.48), CRT (À195 versus À181 lm, p = 0.82), or retinal sensitivity (+3.3 versus +4.1 dB, p = 0.67). Conclusion:In treatment-na€ ıve BRVO patients, addition of navigated central laser to aflibercept did not lower treatment burden or affect functional or anatomical outcomes. A low number of intravitreal injections were needed for successful outcome in both treatment arms.

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Section: Discussionmentioning

confidence: 99%

Navigated laser and aflibercept versus aflibercept monotherapy in treatment‐naïve branch retinal vein occlusion: A 12‐month randomized trial

Frederiksen

Vestergaard

Pedersen

et al. 2022

Acta Ophthalmologica

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“…CMT, defined as the average retinal thickness within the 1-mm ETDRS circle centered on the fovea, was measured using built-in software (Spectralis HRA + OCT). Macular ischemia was evaluated on wide-field FA and SS-OCTA, and it was defined as disruption and enlargement of the foveal avascular zone or a remarkable region of capillary non-perfusion located within one disk diameter of the fovea [ 11 ]. The resolution of ME was defined as the absence of both intraretinal and subretinal fluid on SD-OCT at 12 months.…”

Section: Methodsmentioning

confidence: 99%

Three Monthly Injections Versus One Initial Injection of Ranibizumab for the Treatment of Macular Edema Secondary to Branch Retinal Vein Occlusion: 12-Month Results of a Prospective Randomized Study

Tang

Guo

et al. 2022

Ophthalmol Ther

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Introduction: To compare three monthly injections versus one initial injection of intravitreal ranibizumab (IVR) followed by pro re nata (PRN) dosing to treat macular edema secondary to branch retinal vein occlusion (BRVO).Methods: Seventy-four patients were randomized (1:1) to the 3 ? PRN or 1 ? PRN groups. Patients underwent monthly evaluations and additional IVR injections were administered if the retreatment criteria were met. The functional and anatomical outcomes were recorded. The factors associated with the improvement in best-corrected visual acuity (BCVA) were analyzed. Results: Sixty-nine patients (93.2%) completed the study. At 12 months, the mean gain in BCVA was 12.9 letters in the 3 ? PRN group and 14.3 letters in the 1 ? PRN group, which was not significant (P = 0.59). The mean reduction in central macular thickness was 297.8 lm in the 3 ? PRN group and 300.2 lm in the 1 ? PRN group (P = 0.96). The macular vascular density changes of the superficial and deep capillary plexuses were not significantly different between the two groups (P = 0.99 and 0.70, respectively). The mean number of IVR injections was 5.0 in the 3 ? PRN group and 4.2 in the 1 ? PRN group (P = 0.17). The incidence of retinal neovascularization was similar in both groups (P = 0.67). The baseline BCVA, but not the treatment regimen, was significantly associated with the change in BCVA (P \ 0.01). Conclusion: Significant gains in BCVA and maintenance of macular perfusion were achieved in BRVO eyes treated with the 3 ? PRN or 1 ? PRN regimens. Baseline BCVA was a prognostic factor for the visual improvement.Wenyi Tang and Jingli Guo contributed equally to the work.

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“…In CRVO, the number of injections with PRN regimen in the first year is approximately eight times [ 126 ]. Patients with BRVO are treated for approximately seven times within the first year [ 127 ]. Inadequate treatment may lead to the limited effects.…”

Section: Retinal Vein Occlusionmentioning

confidence: 99%

“…The PLATON study utilized a TAE regimen using aflibercept with an interval of 4 weeks. In this study, the mean visual function of BRVO improved by 23.6 letters at 52 weeks [ 127 ], and the effect on visual improvement was comparable to 6 monthly injections followed by a bimonthly injection [ 140 ]. Arai et al reported a modified TAE regimen with a 4-week interval [ 141 ].…”

Section: Retinal Vein Occlusionmentioning

confidence: 99%

Risk Factors and Treatment Strategy for Retinal Vascular Occlusive Diseases

Terao

Fujino

Ahmed

2022

JCM

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Retinal occlusive diseases are common diseases that can lead to visual impairment. Retinal artery occlusion and retinal vein occlusion are included in the clinical entity, but they have quite different pathophysiologies. Retinal artery occlusion is an emergent eye disorder. Retinal artery occlusion is mainly caused by thromboembolism, which frequently occurs in conjunction with life-threatening stroke and cardiovascular diseases. Therefore, prompt examinations and interventions for systemic vascular diseases are often necessary for these patients. Retinal vein occlusion is characterized by retinal hemorrhage and ischemia, which may impair visual function via several complications such as macular edema, macular ischemia, vitreous hemorrhage, and neovascular glaucoma. Even though anti-vascular endothelial growth factor therapy is the current established first-line of treatment for retinal vein occlusion, several clinical studies have been performed to identify better treatment protocols and new therapeutic options. In this review, we summarize the current findings and advances in knowledge regarding retinal occlusive diseases, particularly focusing on recent studies, in order to provide an update for a better understanding of its pathogenesis.

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Prospective trial of treat-and-extend regimen with aflibercept for branch retinal vein occlusion: 1-year results of the PLATON trial

Cited by 11 publications

References 22 publications

Navigated laser and aflibercept versus aflibercept monotherapy in treatment‐naïve branch retinal vein occlusion: A 12‐month randomized trial

Navigated laser and aflibercept versus aflibercept monotherapy in treatment‐naïve branch retinal vein occlusion: A 12‐month randomized trial

Three Monthly Injections Versus One Initial Injection of Ranibizumab for the Treatment of Macular Edema Secondary to Branch Retinal Vein Occlusion: 12-Month Results of a Prospective Randomized Study

Risk Factors and Treatment Strategy for Retinal Vascular Occlusive Diseases

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