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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


    Dr. Lim reported that intravitreal aflibercept was almost twice as effective at the 24-week time point compared with grid laser therapy. This difference was highly significant (p = 0.0003).

    At the 52-week evaluation, more patients who were treated with intravitreal aflibercept achieved VA increases of 15 or more letters compared with those treated with laser, a difference that also reached significance (p = 0.0296), according to Dr. Lim.

    About half of the study patients experienced an adverse event, 47.8% in the laser with intravitreal aflibercept rescue group and 49.5% in the intravitreal aflibercept group that initially received the drug every 4 weeks and then every 8 weeks.

    The vast majority of adverse events were conjunctival hemorrhages followed by ocular pain and irritation. All of the thromboembolic events and a death occurred in the original laser with intravitreal aflibercept rescue as needed group. One patient each had a nonfatal stroke that occurred before receiving any intravitreal aflibercept rescue and a nonfatal myocardial infarction, and one death from pneumonia occurred during the first 6 months of the study before the patient was treated with aflibercept.

    Laser subgroup analysis

    The investigators conducted a subgroup analysis of the patients in the laser group who were treated with intravitreal aflibercept if they met the criterion. Eligible patients were treated with intravitreal aflibercept every 8 weeks after having been treated with 3 monthly injections of the drug if they met the rescue criterion beginning at week 24, Dr. Lim explained.

    Among the patients in the laser group, by week 52, more than three quarters of the 83 patients who completed 24 weeks of the study received intravitreal aflibercept rescue therapy. The median time to the first rescue injection from baseline was 24.9 weeks (range, 23.1-48.4). Patients received a mean of 4.4 intravitreal injections.

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