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Sirolimus reduces central subfield thickness in eyes with persistent subretinal fluid

Issue: August 2016

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SAN FRANCISCO — Treatment with sirolimus achieved a significant reduction in central subfield thickness in eyes with chronic and persistent fluid after long-term anti-VEGF treatment, according to a study presented here.

“I’d like you to know that these are extremely sick eyes,” Raj K. Maturi, MD, said at the American Society of Retina Specialists annual meeting.

Raj K. Maturi

The prospective, subject-masked, single-center study looked at 40 age-related macular degeneration patients with chronic fluid and continued activity seen on angiogram. One group of patients was randomized to receive 440 µg of sirolimus at baseline, 2 months and 4 months, with sham given at other monthly visits. Another group of patients continued anti-VEGF treatment monthly for 5 months. Subretinal fluid, intraretinal fluid and subretinal tissue were measured by OCT at a masked reading center.

Patients had received an average of 30 to 40 injections before study entry, Maturi said, with active AMD having averaged 6 years of duration in the sirolimus group and 4.5 years in the anti-VEGF group.

The primary endpoint of the study was change in central subfield thickness at 6 months. In the sirolimus group, there was some decrease after the first injection with some edema appearing to return by the second month, Maturi said, but after receiving the second injection of sirolimus at month 2, there was a “significant, consistent and persistent” decrease in central subfield thickness that lasted through month 6. Central subfield thickness in the anti-VEGF group remained “relatively stable,” he said.

Furthermore, the study showed the treatment was associated with a decrease in subretinal fluid and a trend toward decrease in size of subretinal membrane, Maturi said. – by Patricia Nale, ELS

Reference:

Maturi RK. Prospective, randomized, subject-masked evaluation of intravitreal sirolimus vs. anti-VEGF in chronic neovascular AMD with persistent retinal fluid. Presented at: American Society of Retina Specialists annual meeting; Aug. 9-14, 2016; San Francisco.

Disclosure: Maturi reports he is a consultant for Allergan and Graybug Vision and receives research support from Allergan, Allegro, GlaxoSmithKline, Genentech and Santen.