<p>Intravitreal Aflibercept versus Laser Photocoagulation in Asian Patients with Diabetic Macular Edema: The VIVID-East Study</p>

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.

Download Full-text

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

JAMA Ophthalmology ◽

10.1001/jamaophthalmol.2016.4912 ◽

2017 ◽

Vol 135 (2) ◽

pp. 107 ◽

Cited By ~ 5

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

Download Full-text

Faculty Opinions recommendation of Intravitreal Aflibercept for Diabetic Macular Edema: 148-Week Results from the VISTA and VIVID Studies.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726762577.793563440 ◽

2019 ◽

Author(s):

Francesco Bandello ◽

Riccardo Sacconi

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Aflibercept

Download Full-text

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

Ophthalmologica Indonesiana ◽

10.35749/journal.v45i1.172 ◽

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.

Download Full-text

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

Journal of Ophthalmology ◽

10.1155/2018/4171628 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 6

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.

Download Full-text