Navigated laser and aflibercept versus aflibercept monotherapy in treatment-naïve branch retinal vein occlusion: A 12-month randomized trial.

Autor: Frederiksen KH; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Vestergaard JP; Department of Ophthalmology, Odense University Hospital, Odense, Denmark., Pedersen FN; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Vergmann AS; Department of Ophthalmology, Odense University Hospital, Odense, Denmark., Sørensen TL; Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.; Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark., Laugesen CS; Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark., Kawasaki R; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Vision Informatics, Osaka University School of Medicine, Osaka, Japan., Peto T; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK., Grauslund J; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2022 Nov; Vol. 100 (7), pp. e1503-e1509. Date of Electronic Publication: 2022 May 25.
DOI: 10.1111/aos.15182
Abstrakt: Purpose: Angiostatic agents have proven effective in the treatment of macular oedema in patients with branch retinal vein occlusion (BRVO). However, treatment is inconvenient and expensive, and novel treatment regimens are warranted. We aimed to evaluate if combination treatment of navigated central retinal laser and aflibercept lowered the treatment burden in these patients.
Methods: Treatment-naïve patients with BRVO and macular oedema were included at two centres and randomized 1:1 to three monthly injections of 2.0 mg aflibercept with (Group A) or without (Group B) navigated central laser, followed by aflibercept as needed from month 4 through 12. Re-treatment need was evaluated, and secondary endpoints included functional and anatomical outcomes and safety evaluated by retinal microperimetry.
Results: We evaluated 41 eyes of 41 patients with a mean age of 69.6 years. Baseline median best-corrected visual acuity (BCVA) was 70.0 letters, and median central retinal thickness (CRT) was 502 μm with no difference between Groups A (n = 21) and B (n = 20). Percentage of patients needing re-treatment after month three was 71% and 80% (p = 0.72). At month 12, groups did not differ in number of injections after loading (1 versus 2, p = 0.43), change in BCVA (+12.8 versus +15.1 letters, p = 0.48), CRT (-195 versus -181 μm, p = 0.82), or retinal sensitivity (+3.3 versus +4.1 dB, p = 0.67).
Conclusion: In treatment-naïve BRVO patients, addition of navigated central laser to aflibercept did not lower treatment burden or affect functional or anatomical outcomes. A low number of intravitreal injections were needed for successful outcome in both treatment arms.
(© 2022 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
Databáze: MEDLINE
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