Real world data to evaluate the efficacy and safety of intravitreal aflibercept injections for the treatment of macular oedema secondary to Retinal Vein Occlusions (RVO).
Retrospective interventional non-randomized clinical study done at Yeovil District Hospital & NHS Foundation Trust between June 2016 to February 2021.
160 eyes of 160 treatment naïve patients with macular oedema secondary to retinal vein occlusion (73 eyes Branch retinal vein occlusion (BRVO), 80 eyes Central Retinal Vein Occlusion (CRVO) and 7 eyes Hemi Retinal Vein Occlusion (HRVO) treated with intravitreal 2.0 mg Aflibercept injections between June 2016 to February 2021 were included in the study. All the patients received 2 loading dose injections, after which Treat & Extend (T&E) regimen was followed. The primary efficacy end points were, improvement in best-corrected visual acuity (BCVA) from baseline and reduction in Central Retinal Thickness(CRT).
We had a slight female preponderance (51.25 %) with a median age of 76 years. Patients received a median of 8 injections in BRVO eyes, (range 4 to 26) 9 injections (range 3 to 32) in CRVO eyes and 5 (range 2 to 8) injections in HRVO eyes. Median BCVA improved in all patients from baseline to T&E : 35 to 65 letters, 60 to 75 letters and 47.5 to 75 letters in CRVO, BRVO & HRVO eyes respectively and maintained subsequently. 43.13% (69 eyes) gained 15 or more ETDRS letters. Median CRT reduced significantly : CRVO (596 um vs 287.5 um), BRVO (457 um vs 292 um) and HRVO (449 um vs 289 um). 9.37% (15 eyes) had recurrence of disease activity while on T&E regimen and needed long term treatment to maintain the improvement.
Treatment with intravitreal aflibercept provided significant functional and anatomic benefits for all types of retinal vein occlusions. It was well tolerated and none of the patients on treatment developed neovascular complications. Some eyes needed long term treatment to maintain the visual gains.
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