Reduction of Diabetic Macular Edema in the Untreated Fellow Eye Following Intravitreal Injection of Aflibercept

Calvo, Charles M.; Sridhar, Jayanth; Shahlaee, Abtin; Ho, Allen C.

doi:10.3928/23258160-20160419-12

Cited by 12 publications

(10 citation statements)

References 6 publications

(11 reference statements)

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“…This bilateral effect after unilateral injection was also reported in clinical studies and may be attributed to the systemic pharmacokinetics of the administered agent. 53,54 Recent work using popular anti-VEGF agents has demonstrated that aflibercept and bevacizumab have a stronger systemic exposure than ranibizumab. 55 This result is also in agreement with the findings published by Miki et al, 56 who observed a systemic effect of bevacizumab in a transgenic mouse model, but not with ranibizumab.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Characterization of Spontaneous Retinal Neovascularization in the Mouse Eye by Multifunctional Optical Coherence Tomography

Augustin

Wechdorn

Pfeiffenberger

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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Section: Discussionmentioning

confidence: 99%

In Vivo Characterization of Spontaneous Retinal Neovascularization in the Mouse Eye by Multifunctional Optical Coherence Tomography

Augustin

Wechdorn

Pfeiffenberger

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Although ranibizumab is a Fab fragment of a monoclonal anti-VEGF, aflibercept is a recent anti-VEGF agent made of a recombinant fusion protein that binds both VEGF isoforms A and B, and placental growth factor 20. This study compares intravitreal aflibercept and ranibizumab in the treatment of SME in eyes with moderate visual loss.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal aflibercept versus intravitreal ranibizumab for the treatment of diabetic macular edema

Fouda¹,

Bahgat²

2017

OPTH

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PurposeThe purpose of this study was to compare the efficacy of intravitreal aflibercept and ranibizumab in the treatment of diabetic macular edema (DME) in eyes with moderate visual loss.Patients and methodsThis study is a randomized prospective study. Seventy eyes with DME were divided into two groups (each containing 35 eyes). Eyes in group I were treated with intravitreal injection of 2 mg/0.05 mL aflibercept and eyes in group II were treated with intravitreal injection of 0.5 mg/0.1 mL ranibizumab. All the eyes had three successive injections as a loading dose (with 1 month interval), and then the patients were followed up monthly for 12 months. The outcomes of the study were visual acuity, central macular thickness (CMT), and the number of re-injections of the drug.ResultsMean age of the patients in group I was 55.05±4.7 years and in group II was 56.64±5.8 years (P=0.17). The mean baseline best corrected visual acuity (BCVA) of eyes treated with aflibercept was 0.17±0.05 and with ranibizumab was 0.18±0.04 (P=0.9). BCVA was improved in both the groups at the end of the follow-up period and was found to be 0.42±0.28 and 0.37±0.23, respectively (P=0.27). The mean baseline CMT of eyes in group I was 465.29±33.7 µm and in group II was 471.5±34.4 µm (P=0.65). CMT decreased in both the groups to 360.8±85.7 µm and 387.3±87.8 µm, respectively (P=0.2). The mean number of drug re-injection was 2.62±0.68 and 3.03±0.95 in both the groups, respectively (P=0.02).ConclusionAflibercept and ranibizumab have the same efficacy in the treatment of DME in eyes with moderate visual loss but with less number of drug re-injection and less treatment burden with aflibercept (2.62±0.68 versus 3.03±0.95).

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“…Although we did not detect any change in the fellow eye, this does not necessarily mean the IVR had not flowed into the systemic circulation, because the concentration may not be high enough to affect the ocular circulation and cause systemic side-effects. In addition, it has been reported that unilateral intravitreal aflibercept affected the fellow eyes without systemic complications [ 44 – 46 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of intravitreal ranibizumab on the ocular circulation of the untreated fellow eye

Sugimoto

Nunome

Sakamoto

et al. 2017

Graefes Arch Clin Exp Ophthalmol

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PurposeTo evaluate the effects of unilateral intravitreal ranibizumab (IVR) on the ocular circulation of the fellow eyes.MethodsFifteen eyes of 15 patients with macular edema (average age 69.6 ± 11.8 years) were studied. Eleven eyes had diabetic macular edema (DME) and four eyes had macular edema associated with a branch retinal vein occlusion. Each eye received 0.5 mg of IVR. The blood circulation on the optic nerve head of the treated and untreated eyes were determined by laser speckle flowgraphy (LSFG, Softcare Co., Ltd) before, 1 day, and 1 week after the IVR. The mean blur rate (MBR) and the relative changes of the MBRs determined as dMBR(%) = 100−(MBR before/MB after) × 100) were evaluated. The central macular thickness (CMT) and the rate of reduction in the thickness (dCMT = 100−(CMT before/CMT after) × 100) were also evaluated.ResultsThe mean dMBR was significantly higher in the treated eyes than the untreated eyes at 1 day (−16.4 ± 17.0% vs 2.31 ± 19.3%) and at 1 week (−12.0 ± 14.6% vs 4.50 ± 25.9%) after the IVR (P = 0.02, paired t tests).ConclusionThese findings indicate that if ranibizumab enters the systemic circulation, the concentration is not high enough to affect the ocular circulation of the fellow eyes.

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Reduction of Diabetic Macular Edema in the Untreated Fellow Eye Following Intravitreal Injection of Aflibercept

Cited by 12 publications

References 6 publications

In Vivo Characterization of Spontaneous Retinal Neovascularization in the Mouse Eye by Multifunctional Optical Coherence Tomography

In Vivo Characterization of Spontaneous Retinal Neovascularization in the Mouse Eye by Multifunctional Optical Coherence Tomography

Intravitreal aflibercept versus intravitreal ranibizumab for the treatment of diabetic macular edema

Effect of intravitreal ranibizumab on the ocular circulation of the untreated fellow eye

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