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Intravitreal aflibercept for DME improves vision better than laser

Intravitreal aflibercept for diabetic macular edema (DME) continues to perform better than laser with regard to best corrected visual acuity, according to a presentation showing 2-year subgroup analysis data of the VIVID and VISTA DME studies at the Association for Research in Vision and Ophthalmology meeting.


Four hundred six patients in the VIVID study and 466 patients in the VISTA study were divided into three arms: those who underwent laser photocoagulation plus sham injection, those who received five monthly intravitreal injections of 2 mg Eylea(aflibercept, Regeneron) followed by every 4-week dosing plus sham laser, and those who received five monthly 2 mg intravitreal aflibercept injections followed by every 8-week dosing plus sham laser.


Both laser and aflibercept treatments resulted in slightly better visual outcomes in patients with a baseline BCVA between 39 and 60 letters, compared with those with baseline BCVA between 61 and 73 letters, according to the study.


In the VIVID study, mean increase in BCVA in patients with baseline between 39 and 60 letters was 10.5, 10.7 and 1.2, respectively, in the every 4-week arm, the every 8-week arm and the laser arm. The mean increase in BCVA from baseline was 12.5, 10.7, and 0.2 letters in the VISTA study (P < .0001).   Accordingly, mean BCVA increase in patients with baseline between 61 and 73 letters was 9.1, 8.6 and 0.7 in the VIVID study and 10.5, 9.9, and –0.4 letters in the VISTA study.   “The 2-year results continue to show superiority in intravitreal aflibercept vs. laser consistently at 33% vs. 13% with the laser arm with those who lose 15 letters or less,” David Brown, MD, FACS, told Ocular Surgery News.   Patients in both aflibercept arms combined had a lower rate of serious ocular adverse events (1.6%) in the VIVID study than in the laser arm.   “Safety outcomes need to be watched but were pretty close amongst the arms, and we wait for the sister study, VIVID, for further confirmation,” Brown said.   Source: Healio