scholarly journals Intravitreal Aflibercept Injection in Eyes With Substantial Vision Loss After Laser Photocoagulation for Diabetic Macular Edema

2017 ◽  
Vol 135 (2) ◽  
pp. 107 ◽  
Author(s):  
Charles C. Wykoff ◽  
Dennis M. Marcus ◽  
Edoardo Midena ◽  
Jean-François Korobelnik ◽  
Namrata Saroj ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Vision Loss ◽  
Intravitreal Aflibercept

Cost–effectiveness analysis of intravitreal aflibercept in the treatment of diabetic macular edema in China

2020 ◽  
Vol 9 (3) ◽  
pp. 161-175
Author(s):  
Jian Ming ◽  
Yabing Zhang ◽  
Xun Xu ◽  
Mingwei Zhao ◽  
Yusheng Wang ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Cost Effective ◽  
Dominant Strategy ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Intravitreal Aflibercept ◽  
The Cost

Aim: To evaluate the cost–effectiveness of intravitreal aflibercept compared with macular laser photocoagulation and ranibizumab for diabetic macular edema (DME) in China. Methods: A Markov model was developed to reflect the vision changes in DME patients. Parameters were estimated from VIVID-EAST trial data, published literature and physician surveys. Results: In a 20-year horizon, intravitreal aflibercept was associated with 7.825 quality-adjusted life years (QALYs) and 217,841 Chinese Yuan Renminbi (CNY), laser photocoagulation was associated with 7.189 QALYs and 135,489 CNY, and ranibizumab was associated with 7.462 QALYs and 222,477 CNY. The incremental cost–effectiveness ratios were 129,397 CNY/QALY and -12,774 CNY/QALY for intravitreal aflibercept versus laser photocoagulation and ranibizumab, respectively. Conclusion: Intravitreal aflibercept was considered as a cost-effective strategy for DME when compared with laser photocoagulation; it was considered as a dominant strategy when compared with ranibizumab.

scholarly journals Aflibercept for diabetic macular edema: a concise review

2017 ◽  
Vol 6 (5) ◽  
pp. 1031
Author(s):  
Sujithera Haridoss ◽  
Soundaram Meenakshi Sundaram ◽  
Melvin George ◽  
Damal Kandadai Sriram
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Vision Loss ◽  
Standard Of Care ◽  
Management Options ◽  
Treatment Regimens ◽  
Anti Vegf ◽  
Patients With Diabetes ◽  
Vasculogenesis And Angiogenesis

Diabetic retinopathy and diabetic macular edema are associated with loss of vision in patients with diabetes worldwide. The treatment requires a multidisciplinary interventional approach. Among the available management options for DME, laser photocoagulation has been the standard of care. Due to its slow progression and inability to reverse the vision loss, an alternative treatment is needed. The role of vascular endothelial growth factors (VEGF) and inflammatory mediators led to the development of anti-VEGF agents, that stimulates retinal vasculogenesis and angiogenesis. Intravitreal aflibercept is an anti-angiogenic soluble decoy receptor with trap technology employed by fusion of multiple endogeneous receptor component, approved for the treatment of DME. Clinical trials of aflibercept comparing it with laser photocoagulation and other anti-VEGF have shown reliable efficacy, providing significantly positive visual and anatomical results. However, treatment regimens with monthly clinical visits and injections, challenge the patients comfort, thereby requiring the need to identify better strategies to lower injection frequencies.

scholarly journals Intravitreal Aflibercept versus Laser Photocoagulation in Asian Patients with Diabetic Macular Edema: The VIVID-East Study

2020 ◽  
Vol Volume 14 ◽  
pp. 741-750
Author(s):  
You-Xin Chen ◽  
Xiao-Xin Li ◽  
Young Hee Yoon ◽  
Xiaodong Sun ◽  
Yury Astakhov ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Asian Patients ◽  
Intravitreal Aflibercept

scholarly journals Combination of Anti-VEGF and Laser Photocoagulation for Diabetic Macular Edema: A Review

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Laura N. Distefano ◽  
Jose Garcia-Arumi ◽  
Vicente Martinez-Castillo ◽  
Anna Boixadera
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Vision Loss ◽  
Rescue Therapy ◽  
Treatment Protocol ◽  
Macular Thickness ◽  
Diabetic Patients ◽  
Anti Vegf ◽  
Antiangiogenic Drugs

Diabetic macular edema (DME) is the most common cause of vision loss in diabetic patients. Thirty years ago, the Early Treatment Diabetic Retinopathy Study (ETDRS) demonstrated that focal/grid laser photocoagulation reduces moderate vision loss from DME by 50% or more; thus, macular photocoagulation became the gold standard treatment for DME. However, with the development of anti-VEGF drugs (bevacizumab, ranibizumab, and aflibercept), better outcomes were obtained in terms of visual acuity gain and decrease in macular thickness in some studies when antiangiogenic drugs were administered in monotherapy. Macular laser therapy may still play an important role as an adjuvant treatment because it is able to improve macular thickness outcomes and reduce the number of injections needed. Here, we review some of the clinical trials that have assessed the efficacy of macular laser treatment, either as part of the treatment protocol or as rescue therapy.

Current Therapy of Diabetic Macular Edema Bevacizumab, Triamcinolone Acetonide, and Laser Photocoagulation

2019 ◽  
Vol 45 (1) ◽  
pp. 13
Author(s):  
Gladys Kusumowidagdo ◽  
Randy Sarayar ◽  
Kartika Rahayu ◽  
Gitalisa Andayani
Keyword(s):  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Diabetic Macular Edema ◽  
Systematic Reviews ◽  
Laser Photocoagulation ◽  
Meta Analysis ◽  
Intravitreal Bevacizumab ◽  
Current Therapy ◽  
Intravitreal Triamcinolone ◽  
Mesh Terms

Background: Diabetic macular edema (DME) is the main cause of visual impairment in diabetic retinopathy (DR). Current gold standard therapy of DME is macular laser photocoagulation (MPC). Growing evidences have shown benefits of intravitreal anti-VEGF agents (i.e bevacizumab) and intravitreal corticosteroids (i.e triamcinolone acetonide). Aim: To compare the visual acuity (VA) improvement of patients with DME, treated with intravitreal bevacizumab (IVB), a combination of IVB and intravitreal triamcinolone (IVB/IVT), and MPC. Method: A comprehensive PubMed® and Cochrane® databases search was conducted on May 4th, 2017 using appropriate keywords (diabetic macular edema, bevacizumab, triamcinolone, and laser photocoagulation using their MeSH terms). Studies were filtered using inclusion criterions (clinical trials, RCT, meta-analysis, systematic review, English, humans, and publication within 10 years) Results: Three studies (2 systematic reviews and 1 RCT) were found suitable. From these results, all studies showed favoring effects of IVB when compared to IVB/IVT combination and MPC in short term period (up to 6 months). However, there was no significant improvement of VA beyond this period in all groups. Conclusion: IVB appears to be superior to IVB/IVT and MPC in improving VA during 6 months follow- up period. Future systematic reviews and meta-analysis are required on the effect of IVB and MPC combination in cases of DME.

scholarly journals Comparison of Intravitreal Aflibercept and Ranibizumab following Initial Treatment with Ranibizumab in Persistent Diabetic Macular Edema

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Ali Demircan ◽  
Zeynep Alkin ◽  
Ceren Yesilkaya ◽  
Gokhan Demir ◽  
Burcu Kemer
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Medical Records ◽  
Poor Response ◽  
Intravitreal Aflibercept ◽  
The Mean ◽  
Retrospective Comparative Study ◽  
Switch Group ◽  
Persistent Diabetic Macular Edema

Purpose. To compare the visual and anatomic outcomes in patients with persistent diabetic macular edema (DME) who switched from ranibizumab to aflibercept with those who continued with previous ranibizumab therapy. Methods. In this retrospective comparative study, medical records of consecutive patients with center-involved DME ≥ 350 μm who had at least three recent consecutive monthly ranibizumab injections followed by as-needed therapy with either aflibercept or ranibizumab were reviewed. Data were collected at presentation (preinjection), at the intermediary visit, and at the last visit (at the end of the follow-up period). Results. Forty-three eyes of 43 patients were divided into two groups: the switch group (n=20) and the ranibizumab group (n=23). Though no significant improvement was found in the mean BCVA from the intermediary visit to the last visit, there was a difference in the mean CMT in the switch group and the ranibizumab group (p<0.001 and p=0.03, resp.). The mean CMT decreased after the intermediary visit by 188.6 ± 120.5 μm in the switch group and by 60.3 ± 117.1 μm in the ranibizumab group (p=0.003). Conclusions. Both aflibercept and ranibizumab decreased CMT in patients with persistent DME who showed a poor response to ranibizumab injections. However, switching to aflibercept provided only morphologic improvement.

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