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Visual gains more common than losses in anti-VEGF-treated eyes with persistent DME
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BOSTON — On behalf of the DRCR network, John A. Wells, MD, FACS, gave a new analysis of eyes with persistent DME in the Protocol T trial here.
“Even in the presence of chronic, persistent DME, visual acuity gains is the norm and vision loss is uncommon,” Wells said in a presentation at the American Society of Retina Specialists meeting.
The study was undertaken to assess visual and anatomic effects of Eylea (aflibercept, Regeneron), Avastin (bevacizumab, Genentech) and Lucentis (ranibizumab, Genentech) in eyes with persistent diabetic macular edema through 2 years.
“We wanted to know what happens to this group of eyes with DME at 6 months,” Wells said. “What we found was that at baseline, the median baseline vision score and the Snellen equivalent were similar in all three groups, regardless of whether there was persistent DME or not at 24 weeks.”
Eyes with persistent DME at 24 weeks had less vision gain than eyes that had resolution of DME, except in the bevacizumab group where there was no difference, he said.
“We saw a similar trend for 10-letter gainers, and fortunately the rates of vision loss were very low across all three treatment arms,” he said.
From 24 weeks to 2 years, there was a continued slow reduction in eyes with DME over the ensuing 18 months, although eyes in the bevacizumab group were less likely to have resolution, Wells said. There was no statistical difference between rates of resolution at 2 years between aflibercept and ranibizumab.
When comparing vision gains at 2 years, Wells said, “There was this paradoxical situation where eyes in the aflibercept group with persistent DME had more vision gain than those that had resolution of their DME. There was no difference within the bevacizumab group, and more like you would expect, eyes within the ranibizumab group with resolution of DME had more vision gain than had persistent DME. We saw a similar trend for 10-letter gainers, and again the rates of vision loss were low regardless of treatment arm or DME status.”– by Patricia Nale, ELS
Reference:
Wells JA. Persistent macular thickening following intravitreous aflibercept, bevacizumab, or ranibizumab for center-involved DME with vision impairment. Presented at: American Society of Retina Specialists 35th Annual Meeting, Aug. 11-15, 2017; Boston.
Disclosure: Wells reports he is a consultant for Genentech and an investigator for Genentech and Regeneron.