Treatment of macular edema caused by leber's miliary aneurysms using intravitreal aflibercept and peripheral laser photocoagulation

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.

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Coats’ Disease-Related Macular Edema Treated with Combined Aflibercept and Laser Photocoagulation

Case Reports in Ophthalmological Medicine ◽

10.1155/2017/2824874 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Wen-Shi Shieh ◽

Gaurav K. Shah ◽

Kevin J. Blinder

Keyword(s):

Macular Edema ◽

Laser Photocoagulation ◽

Factor V Leiden ◽

Intravitreal Bevacizumab ◽

Poor Response ◽

Factor V ◽

Factor V Leiden Mutation ◽

Intravitreal Aflibercept ◽

Response Switching ◽

Coats Disease

Purpose. To describe the clinical response of refractory macular edema associated with Coats’ disease following treatment with aflibercept and laser photocoagulation. Methods. Case report. Results. A 17-year-old female presented with decreased vision of the left eye. Ophthalmic exam demonstrated intraretinal hemorrhages and exudation with associated edema centrally. Angiographic evaluation revealed central leaking microaneurysms and peripheral capillary dropout. These findings and a systemic work-up that yielded an incidental Factor V Leiden mutation lead to a diagnosis of Coats’ disease. Initial treatment consisted of laser photocoagulation and intravitreal bevacizumab but with poor response. Switching to intravitreal aflibercept resulted in resolution of the refractory macular edema and improvement of visual acuity to 20/25 in the left eye. Conclusion. We describe a case of refractory macular edema which responded more favorably to intravitreal aflibercept compared with bevacizumab when combined with laser photocoagulation in a patient with Coats’ disease.

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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

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Efficacy of Aflibercept in Bevacizumab-Resistant Macular Edema in Adult-Onset Coats Disease

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419877565 ◽

2019 ◽

Vol 3 (6) ◽

pp. 480-484

Author(s):

Cristy A. Ku ◽

Gareth M. Lema

Keyword(s):

Macular Edema ◽

Laser Photocoagulation ◽

Adult Onset ◽

Retrospective Case ◽

Visual Distortion ◽

Anti Vegf ◽

Intravitreal Aflibercept ◽

Antivascular Endothelial Growth Factor ◽

Coats Disease ◽

Endothelial Growth Factor

Purpose: This case is the first to our knowledge that demonstrates the efficacy of intravitreal aflibercept in bevacizumab-resistant, laser-naive macular edema (ME) in adult-onset Coats disease. Methods: A retrospective case report is presented. Results: A 74-year-old woman presented with central visual distortion in her right eye. Imaging and exam were consistent with adult-onset Coats disease with unilateral telangiectatic vessels, numerous macroaneurysms, and peripheral capillary dropout. There were also ME, lipid exudate, and localized hemorrhage. ME failed to respond to 4 intravitreal injections of bevacizumab but dramatically improved following initiation of aflibercept, with patient deferral of laser photocoagulation. Conclusions: To our knowledge, this is the first reported case of aflibercept as the sole treatment of bevacizumab-resistant ME in adult-onset Coats disease. Given the localized macular involvement more common to adult-onset Coats disease, antivascular endothelial growth factor (anti-VEGF) therapy may be sufficient, compared with classic childhood Coats disease, in which anti-VEGF therapy serves as an adjunct to laser photocoagulation or cryotherapy.

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