Prospective Clinical Trial of Intravitreal Aflibercept Treat-and-extend Regimen for Diabetic Macular Edema: 1-Year Outcomes

Hiroki Mieno; Kazuhito Yoneda; Nobuhiro Terao; Kengo Yoshii; Kentaro Kojima; Kenji Nagata; Chie Sotozono

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자료유형: 학술저널

저자정보: Hiroki Mieno (Kyoto Prefectural University of Medicine) Kazuhito Yoneda (Kyoto Prefectural University of Medicine) Nobuhiro Terao (Kyoto Prefectural University of Medicine) Kengo Yoshii (Kyoto Prefectural University of Medicine) Kentaro Kojima (Kyoto Prefectural University of Medicine) Kenji Nagata (Kyoto Prefectural University of Medicine) Chie Sotozono (Kyoto Prefectural University of Medicine)

저널정보: 대한안과학회 Korean Journal of Ophthalmology Korean Journal of Ophthalmology 제34권 제4호

발행연도: 2020.1

수록면: 290 - 296 (7page)

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Purpose: To investigate the efficacy of aflibercept for the treatment of diabetic macular edema via a treat-and-extend regimen. Methods: This prospective, single-center, open-label, interventional study involved 30 patients with a best-corrected visualacuity (BCVA) ≤0.6 and a central retinal thickness (CRT) ≥300 μm. The enrolled eyes each received a monthly intravitreal afliberceptinjection until the CRT decreased below 300 μm, upon which the administration interval was extended for 1 monthuntil the CRT once again increased to ≥300 μm. Main outcome measures were median BCVA and CRT at 6 and 12 monthsafter initiation of treatment via last observation carried forward analysis, the median number of injections over the 12months, and the effects on the diabetic retinopathy severity scale (DRSS) score of the patients who completed the 12-monthfollow-up period. Results: Of the 30 enrolled patients, 29 and 25 respectively completed the 6- and 12-month follow-up examinations. Frombaseline to 6 and 12 months after treatment initiation, the median BCVA (logarithm of the minimum angle of resolution) significantlyimproved from 0.52 to 0.30 and 0.35, respectively, and the median CRT significantly decreased from 439.5 to 268.5and 249.0 μm, respectively. The median number of injections over the 12-month follow-up period was 6.0. Compared tobaseline, the DRSS score at 12 months was improved by 2 steps in 16% of patients; in no cases did the DRSS score worsen orimprove by three steps or more. Conclusions: When administered in a treat-and-extend regimen, aflibercept is an effective treatment option for diabeticmacular edema.

#Aflibercept #Intravitreal injections #Macular edema

참고문헌 (23)

참고문헌 신청

Murata T / 1995 / Vascular endothelial growth factor plays a role in hyperpermeability of diabetic retinal vessels / Ophthalmic Res 27:48~52

Diabetic Retinopathy Clinical Research Network / 2015 / Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema / N Engl J Med 372:1193~1203

Lanzetta P / 2017 / Fundamental principles of an anti-VEGF treatment regimen: optimal application of intravitreal anti-vascular endothelial growth factor therapy of macular diseases / Graefes Arch Clin Exp Ophthalmol 255:1259~1273

Sugimoto M / 2019 / Clinical preferences and trends of anti-vascular endothelial growth factor treatments for diabetic macular edema in Japan / J Diabetes Investig 10:475~483

Nguyen QD / 2012 / Ranibizumab for diabetic macular edema : results from 2 phase III randomized trials : RISE and RIDE / Ophthalmology 119:789~801

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