Two-Year Outcome of Aflibercept Intravitreal Injection in Vitrectomized Eyes with Diabetic Macular Edema

Tran, Thi Ha Chau; Verdun, Stéphane; Rouic, J F Le; Uzzan, J.; Milazzo, S.; Kodjikian, Laurent; Erginay, Ali

doi:10.2147/opth.s352152

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…However, several concerns remain since previous studies on animal models reported controversial findings [ 3 , 4 , 5 ], and all clinical trials excluded vitrectomized eyes. Moreover, real-life clinical studies on the effect of anti-VEGF treatment in vitrectomized eyes were either small case series [ 6 ], did not include a nonvitrectomized eyes control group [ 7 ], or evaluated eyes with disease other than nAMD, such as diabetic macular edema [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Brolucizumab for Neovascular Age-Related Macular Degeneration in a Vitrectomized Eye

Maggio¹,

Alfano²,

Mete³

et al. 2022

Case Rep Ophthalmol

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The efficacy of intravitreal anti-VEGF may be reduced in vitrectomized eyes due to accelerated drug clearance. Given its longer durability, brolucizumab may represent a suitable therapeutic option. However, its efficacy in vitrectomized eyes remains to be explored. Herein, we describe the management of a macular neovascularization (MNV) in a vitrectomized eye with brolucizumab after unsuccessful treatment with other anti-VEGF. A 68-year-old male was treated with pars plana vitrectomy for epiretinal membrane in his left eye (LE) in 2018. After surgery, best corrected visual acuity (BCVA) improved to 20/20 with a remarkable reduction of metamorphopsia. After 3 years, the patient returned, presenting visual loss in the LE due to MNV. He was treated with intravitreal bevacizumab injections. However, after the loading phase, an increased lesion size and exudation with worsening BCVA were detected. Therefore, the treatment was switched to aflibercept. However, after three monthly intravitreal injections, further worsening was recorded. Treatment was then switched to brolucizumab. Anatomical and functional improvement was noticed 1 month after the first brolucizumab injection. Two additional injections were performed, and further improvement was recorded with BCVA recovery to 20/20. At the last follow-up visit 2 months after the third injection, no recurrence was detected. In conclusion, determining whether anti-VEGF injections are efficacious for vitrectomized eyes would be helpful for ophthalmologists managing such patients, as well as when considering pars plana vitrectomy in eyes at risk of MNV. In our case, brolucizumab was found to be effective after unsuccessful treatment with other anti-VEGF. Additional studies are required to evaluate the safety and efficacy of brolucizumab for MNV in vitrectomized eyes.

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Section: Introductionmentioning

confidence: 99%

Intravitreal Brolucizumab for Neovascular Age-Related Macular Degeneration in a Vitrectomized Eye

Maggio¹,

Alfano²,

Mete³

et al. 2022

Case Rep Ophthalmol

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Management of treatment-naïve diabetic macular edema patients: Review of real-world clinical data

Boscia,

Veritti,

Iaculli

et al. 2024

European Journal of Ophthalmology

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The high prevalence of Diabetic macular edema (DME) is a real global health problem. Its complex pathophysiology involves different pathways. Over the last decade, the introduction of intravitreal treatments has dramatically changed the management and prognosis of DME. Among the different treatment options, inhibitors of vascular endothelial growth factor (anti-VEGF) and intravitreal steroids implants represent the first-line therapy of DME. We conducted a review of electronic databases to compile the available evidence about the clinical management of DME in a clinical setting, with a special focus on treatment-naïve patients. Anti-VEGF therapies represent a valuable option for treating DME patients. However, many patients do not respond properly to this treatment and, due to its administration regimen, many patients receive suboptimal treatment in real life. Current evidence demonstrated that in patients with DME, DEX-i improved significantly both anatomic and visual outcomes. Besides eyes with insufficient anti-VEGF respond or recalcitrant DME cases, DEX-i can be effectively and safely used in treatment-naïve DME patients as first line therapy. DEX-i may be considered first line therapy in different clinical scenarios, such as DME eyes with a greater inflammatory component, patients with cardiovascular events, vitrectomized eyes, or those requiring cataract surgery. In conclusion, there are still many points for improvement pending in the clinical management of the patient with DME. Since DME treatment must follow a patient-tailored approach, selecting the best therapeutic approach for each patient requires a good understanding of the pathophysiology of DME.

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Short-term experience of intravitreal brolucizumab in treatment of diabetic macular edema

Куликов¹,

Kalinicheva²,

Maltsev³

et al. 2023

Vestn. oftal'mol.

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Two-Year Outcome of Aflibercept Intravitreal Injection in Vitrectomized Eyes with Diabetic Macular Edema

Cited by 3 publications

References 21 publications

Intravitreal Brolucizumab for Neovascular Age-Related Macular Degeneration in a Vitrectomized Eye

Intravitreal Brolucizumab for Neovascular Age-Related Macular Degeneration in a Vitrectomized Eye

Management of treatment-naïve diabetic macular edema patients: Review of real-world clinical data

Short-term experience of intravitreal brolucizumab in treatment of diabetic macular edema

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