Journals / Retina-Vitreus / 2019 / Cilt: 28 - Sayı: 1

The Results of Afl ibercept Treatment in Patients With Naive Diabetic Macular Edema: A Real World Study

Tedavi Olmamış Diabetik Makula Ödemi Olan Hastalarda Afl ibercept Tedavisi: Gerçek Yaşam Verileri

Pages
73–78
Publication Date
2022-10-17
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Clinicians could decrease the number ofinjections with using as-needed treatment regimen, with a comparable improvement of visual acuity..

📌 3 Key Takeaways

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Objective & Hypothesis:Purpose: To present the long-term results of afl ibercept treatment in patients with no previous treatment for diabetic macular edema (DME) indaily clinical practice.Method: A retrospective, single-center study designed to evaluate the functional and anatomic outcomes of intravitreal afl ibercept treatmentin patients with no previous treatment for DME.
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Key Findings & Data:The patients included in this study had DME defi ned by the loss of the foveal pit and centralmacular thickness (CMT) greater than 300 μm on OCT.
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Conclusion & Impact:Clinicians could decrease the number ofinjections with using as-needed treatment regimen, with a comparable improvement of visual acuity..
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Purpose: To present the long-term results of afl ibercept treatment in patients with no previous treatment for diabetic macular edema (DME) indaily clinical practice.Method: A retrospective, single-center study designed to evaluate the functional and anatomic outcomes of intravitreal afl ibercept treatmentin patients with no previous treatment for DME. The patients included in this study had DME defi ned by the loss of the foveal pit and centralmacular thickness (CMT) greater than 300 μm on OCT. Only patients who received at least the fi rst 3 monthly (4 weeks) afl ibercept (2 mg/0.05 cc)injections were included in the study. Retreatment was performed if a loss of best corrected visual acuity (BCVA) ≥5 letters were defi ned between2 consecutive visits or CMT worsened which CMT of >300 micron, or increase in CMT by > 10 %.Results: The mean BCVA (Logarithm of the minimum angle of resolution or recognition -logMAR) increased to 0.55±0.40 (0.1-2.0) after applyinga mean of 3.2±0.53 afl ibercept injections (p= 0.001). At the fi nal examination, mean letter gain was 13.5±15.7 letters. At the fi nal examination,gains in Early Treatment Diabetic Retinopathy Study (ETDRS) letters were documented in 44 eyes (69.8%), and visual acuity remained stable in19 eyes (30%). The mean CMT was 430.8±135.39 μm (242-806) before initiating treatment with afl ibercept and decreased to 303.6±57.7 μm (210-529) at the fi nal examination (p= 0.0001).Conclusion: Afl ibercept could be used as a fi rst-line therapy in patients with treatment-naive DME. Clinicians could decrease the number ofinjections with using as-needed treatment regimen, with a comparable improvement of visual acuity..

Özet

Amaç: Diyabetik maküla ödemi (DMÖ) nedeniyle daha önce tedavi almamış hastalarda günlük klinik şartlarda uygulanan afl ibercept tedavisinin uzun dönem sonuçlarını sunmak. Yöntem: Çalışma DMÖ tedavisi uygulanmamış olgularda intravitreal afl ibercept tedavisinin anatomik ve fonksiyonel sonuçlarını araştırmak amacıyla tek merkezde retrospektif olarak dizayn edildi. Çalışmaya dahil edilen hastalarda optik koherens tomografi de (OKT) 300 μm dan yüksek santral makula kalınlığı (SMK) ve foveal çukurluğun silinmesi ile tanımlanan diabetik makular ödem mevcuttu. En az ilk 3 yükleme dozu (4 hafta aralıklı) afl ibercept (2 mg/0.05 cc) tedavisi uygulanmış olan hastalar çalışmaya dahil edildi. Ardışık iki vizite en iyi düzeltilmiş görme keskinliğinde (EİDGK) ≥5 harf kayıp olması, santral makula kalınlığının 300 μm dan yüksek olması veya santral makula kalınlığının %10 dan fazla artması durumunda ek tedavi uygulandı. Bulgular: Ortalama 3.2 ± 0.53 afl ibercept enjeksiyonu uygulanmasını takiben ortalama EİDGK (logMAR), 0.55 ± 0.40’a (0.1-2.0) yükseldiği saptandı (p = 0.001). Son vizitte, ortalama harf kazanımının 13.5 ± 15.7 harf olduğu belirlendi. 44 gözde (% 69,8) görme keskinliğin artış olduğu ve görme keskinliğinin 19 gözde (% 30) stabil kaldığı belirlendi. Ortalama SMK nin, afl ibercept ile tedavisini takiben son muayenede 430.8 ± 135.39 μm (242-806) dan 303.6 ± 57.7 μm’ye (210-529) düştüğü izlendi. (p = 0.0001). Sonuç: Bu çalışma afl ibercept tedavisinin diabetik makular ödemi olan hastalarda birinci basamak tedavi olarak kullanılabileceğini desteklemektedir. Klinisyenler, gerektiğinde ek enjeksiyonlar uygulayarak, görme keskinliğinde karşılaştırılabilir bir iyileşme sağlayıp, enjeksiyon sayısını azaltmaları mümkündür.

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Cite This Article

ÜNSAL, E., ÇUBUK, M. Ö. (2022). The Results of Afl ibercept Treatment in Patients With Naive Diabetic Macular Edema: A Real World Study. Retina-Vitreus, Cilt: 28 - Sayı: 1, 73–78. https://ajindex.com/articles/589117

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References (9)

  1. Romero-Araca P. “Managing diabetic macular edema: the leading cause of diabetes blindness,” World J Diabetes. 2011 Jun 15;2(6):98-104 Yau JW,Rogers SL, Kawasaki R,et al. “Global prevalence and major risk factors of diabetic retinopathy,” Diabetes Care. 2012 Mar;35(3):556-64. Delcourt C,Massin P, Rosilio H. Epidemiology of diabetic retinopathy: expected vs reported prevalence of cases in the French population, Diabetes Metab. 2009 Dec;35(6):431-8
  2. Bandello F, Cicinelli MV, Parodi MB. Anti-VEGF molecules for the management of diabetic macular edema. Curr Pharm Des. 2015;21(32):4731–47.
  3. Fogli S, Mogavero S, Egan CG, Del Re M, Danesi R. Pathophysiology and pharmacological targets of VEGF in diabetic macular edema. Pharmacol Res. 2016;103:149–157 Stewart MW. The expanding role of vascular endothelial growth factor inhibitors in ophthalmology. Mayo Clin Proc. 2012;87(1):77–88.
  4. Wells JA, Glassman AR, Ayala AR, Jampol LM, Aiello LP, Antoszyk AN, Arnold-Bush B, Baker CW, Bressler NM, Browning DJ, Elman MJ, Ferris FL, Friedman SM, Melia M, Pieramici DJ, Sun JK, Beck RW(2015) Afl ibercept, bevacizumab, or ranibizumab for diabetic macular edema. N Engl J Med. 2015 Mar 26;372(13):1193-203
  5. Wells JA, Glassman AR, Ayala AR, Jampol LM, Bressler NM, Bressler SB, Brucker AJ, Ferris FL, Hampton GR, Jhaveri C, Melia M, Beck RW, Diabetic Retinopathy Clinical Research Network (2016) Afl ibercept, bevacizumab, or ranibizumab for diabetic macular edema: two-year results from a comparative effectiveness randomized clinical trial. Ophthalmology. 2016 Jun;123(6):1351-9 Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs an extension of the modifi ed Airlie House classifi cation. ETDRS report number 10. Ophthalmology. 1991;98(5 Suppl):786–806.
  6. Korobelnik JF, Do DV, Schmidt-Erfurth U, et al. Intravitreal afl ibercept for diabetic macular edema. Ophthalmology. 2014;121(11):2247–54.
  7. Brown DM, Schmidt-Erfurth U, Do DV, et al. Intravitreal afl ibercept for diabetic macular edema: 100-week results from the VISTA and VIVID studies. Ophthalmology. 2015;122(10):2044–52
  8. Campos Polo R, Rubio Sanchez C, Garcia Guisado DM, Diaz Luque MJ. Afl ibercept for clinically signifi cant diabetic macular edema: 12- month results in daily clinical practice. Clin Ophthalmol. 2018 Jan 8; 12:99-104
  9. Fouda SM, Bahgat AM. Intravitreal afl ibercept versus intravitreal ranibizumab for the treatment of diabetic macular edema. Clin Ophthalmo