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    Rescue alfibercept treatment proves successful for patients with BRVO

    Improved, sustained VA outcomes for branch retinal vein occlusion patients compared with laser

    Take-home message: Patients with branch retinal vein occlusion had better visual outcomes and decreased macular edema following intravitreal injection of aflibercept compared with laser treatment.


    Chicago—Rescue treatment with intravitreal aflibercept (Eylea, Regeneron Pharmaceuticals) provides significant visual benefits in patients treated with grid laser for macular edema associated with branch retinal vein occlusion (BRVO) at week 52 of the VIBRANT Study, said Jennifer Lim, MD.

    The VIBRANT Study was a 52-week, phase III trial in which 183 eyes with BRVO with macular edema were randomized to either 2 mg of intravitreal aflibercept every 4 weeks beginning at baseline for 24 weeks (n = 91 eyes) or grid laser treatment at baseline (n = 92 eyes), explained Dr. Lim, director of retina, Marion H. Schenk Chair and professor of ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois at Chicago.

    The primary endpoint at 24 weeks was the percentage of patients with a three-line increase (15 letters or more) in visual acuity (VA).

    The secondary endpoints were the mean changes in the best-corrected VA (BCVA) and the central retinal thickness (CRT). At 24 weeks, the eyes treated with intravitreal aflibercept received 2 mg of the drug every 8 weeks and rescue laser if needed at 36 weeks. The eyes that were randomly assigned to laser were treated with rescue intravitreal aflibercept if needed.

    These eyes received 2 mg of intravitreal aflibercept rescue therapy every 8 weeks following 3 monthly doses of intravitreal aflibercept.

    To qualify for this treatment, the patients must have had a greater than 50-μm increase from lowest previous CRT, new or persistent cystic retinal changes or subretinal fluid or persistent diffuse edema in the central subfield, and loss of 5 or more letters from the best previous measurement with any increase in CRT.

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