Comparison of Short-Term Clinical Outcomes between Intravitreal Ranibizumab and Aflibercept in Retinal Angiomatous Proliferation

Oh Jae Kim; Jae Hui Kim; Jong Woo Kim; Tae Gon Lee; Sung Won Cho; Dong Won Lee; Jung Il Han; Chul Gu Kim

doi:10.3341/jkos.2016.57.2.243

Journal List > J Korean Ophthalmol Soc > v.57(2) > 1010502

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Kim, Kim, Kim, Lee, Cho, Lee, Han, and Kim: Comparison of Short-Term Clinical Outcomes between Intravitreal Ranibizumab and Aflibercept in Retinal Angiomatous Proliferation

Original Article

J Korean Ophthalmol Soc 2016;57(2):243-247.

Published online: 7 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.2.243

Comparison of Short-Term Clinical Outcomes between Intravitreal Ranibizumab and Aflibercept in Retinal Angiomatous Proliferation

Oh Jae Kim, MD, Jae Hui Kim, MD, Jong Woo Kim, MD, Tae Gon Lee, MD, Sung Won Cho, MD, Dong Won Lee, MD, Jung Il Han, MD, Chul Gu Kim, MD

Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea

Address reprint requests to Chul Gu Kim, MD Department of Ophthalmology, Kim's Eye Hospital, #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 07301, Korea Tel: 82-2-2671-7665, Fax: 82-2-2671-6359 E-mail: chulgukim@kimeye.com

Received 10 September 2015 Revised 7 October 2015 Accepted 12 December 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the 6-month outcomes of intravitreal ranibizumab and aflibercept treatment for patients with retinal angiomatous proliferation (RAP).

Methods

A retrospective review of medical records of 28 patients (31 eyes) diagnosed with RAP was performed. All patients were initially treated with 3 consecutive intravitreal ranibizumab or aflibercept injections after diagnosis. Additional treatment was performed when exudation recurred. The best-corrected visual acuity (BCVA) and central foveal thickness were measured before the first injection and 3 and 6 months after the first injection. The values measured before the treatment were compared with those after treatment.

Results

Sixteen eyes were treated with ranibizumab and 15 eyes with aflibercept. The logarithm of minimal angle of resolution (log MAR) values of BCVA before the first injection and 3 and 6 months after the first injection were 0.78 ± 0.50, 0.47 ± 0.30 and 0.59 ± 0.41 in the ranibizumab group and 0.96 ± 0.52, 0.83 ± 0.52 and 0.74 ± 0.56 in the aflibercept group, respectively. Central foveal thickness was 315.75 ± 115.44, 188.38 ± 57.33 and 218.50 ± 96.49 μm in the ranibizumab group and 249.00 ± 74.88, 143.73 ± 32.73 and 196.73 ± 94.08 μm in the aflibercept group, respectively. BCVA was significantly improved and central foveal thickness was significantly reduced at 6 months (p < 0.05) compared to measurements before the first injection in both groups. However, BCVA improvement and central foveal thickness were not significantly different between the 2 groups.

Conclusions

Both intravitreal ranibizumab and aflibercept treatments were beneficial for both normalizing macular thickness and improving visual acuity in patients with RAP. The efficacy of the 2 drugs was not noticeably different.

Keywords: Aflibercept, Clinical outcomes, Ranibizumab, Retinal angiomatous proliferation

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Figure 1.

Six-months changes in BCVA (log MAR) and central foveal thickness in eyes with retinal angiomatous proliferation that were treated with ranibizumab (solid line) or aflibercept (dotted line) treatment, according to the follow-up period. (A) BCVA (log MAR). (B) Central foveal thickness. BCVA = best-corrected visual acuity; log MAR = logarithm of minimal angle of resolution.

Table 1.

Comparisons of characteristics of 31 included eyes (28 patients) with retinal angiomatous proliferation

Characteristics	Ranibizumab	Aflibercept	p-value
Age (years)	75.19 ± 6.36	73.47 ± 7.80	0.928^*
Sex (n, %)			0.843^†
Male	3 (20.0)	3 (23.1)
Female	12 (80.0)	10 (76.9)
log MAR BCVA before 1st injection	0.78 ± 0.50	0.96 ± 0.52	0.338^*
log MAR BCVA 6 months after 1st injection	0.59 ± 0.41	0.74 ± 0.56	0.682^*
Amount of change in log MAR BCVA during 6 months	−0.19 ± 0.31	−0.10 ± 0.61	0.770^*
CRT before 1st injection (μ m)	315.75 ± 115.44	249.00 ± 74.88	0.078^*
CRT 6 months after 1st injection (μ m)	218.50 ± 96.49	196.73 ± 94.08	0.520^*
Amount of change in CRT during 6 months (μ m)	−97.25 ± 125.73	−52.27 ± 87.44	0.470^*
Number of anti-VEGF injections	3.50 ± 0.63	3.20 ± 0.56	0.188^*
Number of eyes required 4th injection (%)	7 (43.75)	2 (13.3)	0.062^†

Values are presented as mean ± SD unless otherwise indicated.

SD = standard deviation; logMAR = logarithm of minimal angle of resolution; BCVA = best-corrected visual acuity; CRT = central retinal thickness; VEGF = vascular endothelial growth factor.

^* p-value by Mann-Whitney U-test;

^† p-value by Chi-square test.

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