Effect of aflibercept on persistent macular edema secondary to central retinal vein occlusion

Abstract

Purpose. - To evaluate the efficacy of switching treatment from intravitreal ranibizumab to intravitreal aflibercept on the treatment of refractory macular edema secondary to central retinal vein occlusion (CRVO). Methods. - In this retrospective study; 12 eyes with refractory macular edema secondary to CRVO after multiple monthly repeated intravitreal 05 mg/0.05 mL ranibizumab injections prior to switching therapy to intravitreal 2 mg/0.05 mL aflibercept, between March 2012 and April 2016 were reviewed. The follow-up time was 12 months. Changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), central retinal volume (CRV) and injection interval between baseline and month 1, 3, 6 and 12 after switching therapy to aflibercept were reviewed and evaluated. Results. - Mean baseline CRT decreased from 516 +/- 101 mic. to 252 +/- 114 mic.at month 12 (P=0.008). Mean baseline CRV decreased from 8.74 +/- 2.13mm(3) to 6.82 +/- 1.64mm(3) at month 12 (P=0.005). Baseline BCVA improved from 0.73 +/- 0.21 to 0.53 +/- 0.17 logMAR at month 12 (P=0.004). Mean BCVA gain was two logMar lines (10 letters) at month 12. After switching therapy to aflibercept; the mean injection interval increased significantly from 1.34 months at baseline to 1.86 months at month 12, by an increase of 0.52 months (P=0.02). Conclusion. - Intravitreal aflibercept is evaluated to be presenting significant visual and anatomical improvements in patients with persistent macular edema due to CRVO despite previous intravitreal ranibizumab.