scholarly journals Predictors for 2-year functional and morphological outcomes of a treat and extend regimen with ranibizumab in patients with diabetic macular edema

2021 ◽  
Author(s):  
Helena Giannakaki-Zimmermann ◽  
Alexandra Behrndt ◽  
Laura Hoffmann ◽  
Maria-Magdalena Guichard ◽  
Cengiz Tuerksever ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Loading Dose ◽  
Treatment Frequency ◽  
Treat And Extend ◽  
Free Treatment ◽  
Younger Age ◽  
One Year ◽  
Treat And Extend Regimen

Abstract Purpose: To investigate longer-term functional and morphological outcomes and their predictors in diabetic macular edema (DME) following a treat and extend regimen (TER) without loading dose under ranibizumab. Methods: Patient data were reviewed and analyzed retrospectively over a period of 24 months after initiation of TER. Best-corrected visual acuity (BCVA), treatment frequency as well as quantitative and qualitative Spectral-domain Optical Coherence Tomography parameters were assessed. Results: 118 eyes of 87 patients were included. A mean of 9.742.13 injections in the first and 7.632.29 in the second year were applied. There were significant gains of BCVA and reductions in central retinal thickness from baseline to month 12 and 24 (all p<0.001). Percentage of eyes with an intact inner-/outer segment (IS/OS) junction increased from 15.3% at baseline to 42.1% at month 24 (p<0.001). An intact IS/OS junction at baseline increased the probability of having a dry retina after 12 months by 79.3% (p=0.017) and after 24 months by 88.1% (p=0.040). Less IS/OS disruption at baseline predicted longer maximum recurrence-free treatment intervals at 2 years (r=-0.345, p<0.001) and better BCVA at one year (r=-0.347, p<0.001). Baseline bigger intraretinal cysts were associated with more IS/OS disruption at 24 months (r=0.305, p=0.007). Younger age and lower BCVA at baseline were predictive for a higher BCVA gain at 24 months (p=0.046, p<0.001). Conclusion: Ranibizumab applied in a TER without loading dose in DME significantly improves visual acuity and retinal anatomical structure throughout two years. The evaluated predictors might help to guide routine clinical treatment in DME.

scholarly journals Comparison of outcomes between intravitreal ranibizumab and intravitreal aflibercept for diabetic macular edema with “Treat-and-Extend” regimen

2019 ◽  
Author(s):  
Masahiko Sugimoto ◽  
Shinichiro Chujo ◽  
Taku Sasaki ◽  
Atsushi Ichio ◽  
Ryohei Miyata ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Ranibizumab ◽  
Treat And Extend ◽  
Corrected Visual Acuity ◽  
Intravitreal Aflibercept ◽  
Number Of Injections ◽  
Best Corrected Visual Acuity ◽  
Treat And Extend Regimen

Abstract Background To compare the effectiveness of intravitreal ranibizumab (IVR) and aflibercept (IVA) with the Treat-and-Extend (TAE) regimen for diabetic macular edema (DME).Patients and methods Thirteen eyes received an intravitreal injection of 0.5 mg ranibizumab (mean age, 70.9±6.0 years) and 13 eyes received 2 mg aflibercept (65.9±8.6 years). After 3 consecutive monthly injections, they received additional injections with the TAE regimen. The changes in the best-corrected visual acuity (BCVA), CRT, and total number of injections were compared.Results No significant differences were detected in the baseline demographics. The BCVA was significantly improved for both groups; 0.31±0.19 to 0.10±0.12 logMAR units for IVR and 0.41±0.19 to 0.16±0.28 logMAR units for IVA at 24 months ( P <0.01). The CRT was significantly reduced in both groups; 440.9±69.3 to 307.5±66.4 μm for IVR and 473.9±71.5 to 317.8±71.2 μm for IVA at 24 months ( P <0.01). No significant differences were detected in the improvements of the BCVA and reduction in the CRT between them. The total number injections were significant fewer for the IVA group (11.0±1.2) than the IVR group (12.0±1.0) at 24 months ( P =0.02).Conclusion The results showed that the TAE regimen was effective. The IVA group required fewer injections to attain the same improvements.

scholarly journals One-year outcomes of the treat-and-extend regimen using aflibercept for the treatment of diabetic macular edema

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Shwu-Jiuan Sheu ◽  
Chang-Hao Yang ◽  
Chi-Chun Lai ◽  
Pei-Chang Wu ◽  
Shih-Jen Chen
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treat And Extend ◽  
One Year ◽  
Treat And Extend Regimen

One-Year Results of Using a Treat-and-Extend Regimen without a Loading Phase with Anti-VEGF Agents in Patients with Treatment-Naive Diabetic Macular Edema

2019 ◽  
Vol 241 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Petra Schwarzer ◽  
Andreas Ebneter ◽  
Marion Munk ◽  
Sebastian Wolf ◽  
Martin S. Zinkernagel
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treat And Extend ◽  
Anti Vegf ◽  
Treatment Naïve ◽  
One Year ◽  
Treat And Extend Regimen

scholarly journals Comparison of outcomes between intravitreal ranibizumab and intravitreal aflibercept for diabetic macular edema with “Treat-and-Extend” regimen

2020 ◽  
Author(s):  
Masahiko Sugimoto ◽  
Shinichiro Chujo ◽  
Taku Sasaki ◽  
Atsushi Ichio ◽  
Ryohei Miyata ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Intravitreal Ranibizumab ◽  
Treat And Extend ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Intravitreal Aflibercept ◽  
Treatment Naïve ◽  
Treat And Extend Regimen

Abstract Background To compare the effectiveness of intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) performed with the Treat-and-Extend (TAE) regimen on eyes with diabetic macular edema (DME).Patients and methods This was a retrospective study of 125 eyes of 125 treatment naïve DME patients who received anti-VEGF injections at 3 consecutive monthly intervals as the loading phase. Of these 125 eyes, 26 eyes completed the treatment with the TAE regimen for at least 24 months. Among the 26 eyes, 13 eyes of 13 patients (mean age, 70.9±6.0 years) received intravitreal injections of 0.5 mg ranibizumab and 13 eyes of 13 patients (65.9±8.6 years) received 2 mg aflibercept. The changes in the best-corrected visual acuity (BCVA), central retinal thickness (CRT), diabetic retinopathy severity (DRS), and total injection numbers were compared between the two anti-VEGF agents.Results No significant differences were detected in the baseline demographics. At 24 months, the BCVA was significantly improved in both groups; from 0.31±0.19 to 0.10±0.12 logMAR units for IVR and 0.41±0.19 to 0.16±0.28 logMAR units for IVA ( P=1.29x10 -9 ). The CRT was significantly reduced in both groups; 440.9±69.3 to 307.5±66.4 μm for IVR and 473.9±71.5 to 317.8±71.2 μm for IVA ( P=3.55x10 -9 ). No significant differences were detected in the improvements of the BCVA and the CRT in both groups, and the total injection numbers were significant fewer for the IVA group (11.0±1.2) than the IVR group (12.0±1.0). The DRS was significantly improved in both groups ( P =0.0004 for IVR and P =0.009 for IVA).Conclusion No significant differences were detected in the improvements of the BCVA or CRT and injection numbers between IVR and IVA groups treated with the TAE regimen. These results indicate that the results of the treatment with both agents with the TAE regimen were equally effective.

scholarly journals One-Year Results of Treatment of Diabetic Macular Edema with Aflibercept Using the Treat-and-Extend Dosing Regimen: the VIBIM Study

2020 ◽  
Vol 243 (4) ◽  
pp. 255-262
Author(s):  
Kang Yeun Pak ◽  
Jae Pil Shin ◽  
Hyun Woong Kim ◽  
Min Sagong ◽  
Yu Cheol Kim ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Dosing Regimen ◽  
Treat And Extend ◽  
Results Of Treatment ◽  
One Year

scholarly journals Intralenticular Ozurdex® – One Year Later

2017 ◽  
Vol 8 (3) ◽  
pp. 590-594 ◽  
Author(s):  
Kathleen A. Regan ◽  
Charles R. Blake ◽  
Zachary L. Lukowski ◽  
Siva S.R. Iyer
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Crystalline Lens ◽  
Cataract Extraction ◽  
Dexamethasone Implant ◽  
Cataract Formation ◽  
Refractory Diabetic Macular Edema ◽  
One Year

Reported here is a case of intralenticular sustained-release dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) present for 1 year with effective treatment of refractory diabetic macular edema without rapid cataract formation. The crystalline lens remained stable for 12 months on exam despite the presence of the steroid-secreting foreign body. The diabetic macular edema resolved on exam and on optical coherence tomography. After 1 year, cataract extraction was uneventfully performed by phacoemulsification for a mild decline in visual acuity. Macular edema remains resolved 2 months following cataract removal. This is the longest reported period of observation of intralenticular Ozurdex in the literature. Ozurdex remains effective despite intralenticular location, and it can have minimal effects on cataract progression.

scholarly journals Age, Initial Central Retinal Thickness, and OCT Biomarkers Have an Influence on the Outcome of Diabetic Macular Edema Treated With Ranibizumab– Tri-center 12-Month Treat-and-Extend Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Chun-Ting Lai ◽  
Yi-Ting Hsieh ◽  
Chun-Ju Lin ◽  
Jia-Kang Wang ◽  
Chih-Ying Lin ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Central Retinal Thickness ◽  
Treat And Extend ◽  
Corrected Visual Acuity ◽  
Therapeutic Outcomes ◽  
Younger Age ◽  
To Receive ◽  
Anatomical Outcomes

Objective: We report the tri-center 1-year outcomes of a treat-and-extend (T&amp;E) regimen in four-week intervals with ranibizumab for diabetic macular edema (DME).Methods: In this retrospective study, all eyes received 3 monthly loading injections of 0.5 mg ranibizumab, followed by a T&amp;E regimen for DME. Regression models were used to evaluate the associating factors for visual and anatomical outcomes.Results: Ninety one eyes from 64 patients were enrolled. Mean LogMAR best-corrected visual acuity (BCVA) improved from 0.58 at baseline to 0.36 at month 12 and mean central retinal thickness (CRT) decreased from 411 μm at baseline to 290 μm at month 12. Younger age and eyes having thinner baseline CRT, with ellipsoid zone disruption (EZD), and without epiretinal membrane (ERM) were associated with better final CRT. Moreover, eyes with thicker baseline CRT tend to receive more injections. Among the parameters, only having ERM or EZD was associated with significant BCVA recovery.Conclusions: A T&amp;E regimen with ranibizumab by 4-week intervals is effective in improving BCVA and reducing CRT with efficacy notable starting from the third month. Clinical parameters including age, initial CRT, and presence of ERM or EZD significantly influenced therapeutic outcomes. Moreover, the presence of ERM should not preclude DME patients from receiving anti-VEGF therapy. Future studies with larger cohorts are warranted.

scholarly journals Autofluorescence indexes as biomarkers for antiangiogenic loading dose outcome in diabetic macular edema

2020 ◽  
Vol 12 ◽  
pp. 251584142094266
Author(s):  
Sergio E. Hernández Da Mota ◽  
Francisco Béjar Cornejo ◽  
Marcela Esquivel Velázquez ◽  
Virgilio Lima Gómez ◽  
Gerardo González Saldívar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Contrast Sensitivity ◽  
Diabetic Macular Edema ◽  
Fundus Autofluorescence ◽  
Factor Loading ◽  
Sensitivity Index ◽  
Loading Dose ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose: To evaluate the combination of fundus autofluorescence results with several clinical and structural variables into mathematical indexes to enhance their ability to predict visual and anatomical changes after the antivascular endothelial growth factor loading dose. Methods: Patients with diabetic macular edema were enrolled. Each patient had a comprehensive ophthalmological examination, contrast sensitivity, optical coherence tomography, and fundus autofluorescence assessment. All patients received three monthly doses of ziv-aflibercept and were followed each month for response assessment. Autofluorescence was classified according to its level into five grades. The grades were combined with other variables (best-corrected visual acuity, contrast sensitivity, central macular thickness, macular cube volume, and macular cube average thickness) into normalized indexes. Statistical assessment was done using a Spearman’s rank correlation coefficient, linear regression, and interobserver-agreement analysis. Results: There was a strong correlation between the fundus autofluorescence/baseline best-corrected visual acuity index and the fundus autofluorescence/contrast-sensitivity index at baseline with the best-corrected visual acuity after the third dose of ziv-aflibercept ( rs = −0.78, p = .000 and rs = −0.68, p = .0009 respectively). The fundus autofluorescence/baseline best-corrected visual acuity index and the fundus autofluorescence/contrast-sensitivity index, both at baseline had a mild correlation with the macular volume at 1 month of follow-up ( rs = 0.56, p = .008 and ( rs = 0.64, p = .002, respectively). Conclusion: This study suggests that it is possible to combine fundus autofluorescence results with functional and structural variables into normalized indexes that could potentially predict outcomes after antivascular endothelial growth factor loading dose in patients with diabetic macular edema.

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