Journal of VitreoRetinal Diseases最新文献

{"title":"The Efficacy and Safety of Intravitreal Aflibercept 8 mg in Clinical Practice.","authors":"Brandon A Bates, Hana A Mansour, Hasenin Al-Khersan, Edward Wood, Bita Momenaei, Eric Schneider, Collin J Richards, Charles DeYoung, Charles C Wykoff, Kevin Quinn, Jason Hsu, Carl D Regillo, Allen C Ho, Mitchell S Fineman, Michael A Klufas, Philip P Storey","doi":"10.1177/24741264251383384","DOIUrl":"10.1177/24741264251383384","url":null,"abstract":"<p><p><b>Purpose:</b> To characterize real-world use of intravitreal aflibercept 8 mg across 22 US retina practices. <b>Methods:</b> Retrospective review of patients who received at least 1 intravitreal aflibercept 8 mg injection for treatment of neovascular age-related macular degeneration, diabetic macular edema, or diabetic retinopathy through April 1, 2024. Data from health records were collected retrospectively, including best-corrected visual acuity (BCVA), interval between treatments, and adverse events. <b>Results:</b> A total of 8323 eyes of 6271 patients received 20 385 intravitreal aflibercept 8 mg injections. A total of 669 eyes (8.0%) were not previously treated. Among treatment-naive eyes, mean logMAR BCVA improved from 0.57 (Snellen equivalent ~20/80) at the time of the first intravitreal aflibercept 8 mg injection, to 0.47 (Snellen equivalent ~20/60) (<i>P</i> < .001), 0.46 (Snellen equivalent ~20/60) (<i>P</i> < .001), and 0.48 (Snellen equivalent ~20/60) (<i>P</i> = .012) at the second, third, and fourth intravitreal aflibercept 8 mg injections, respectively. Among previously treated eyes, mean logMAR BCVA improved from 0.46 (Snellen equivalent ~20/60) at the time of the first intravitreal aflibercept 8 mg injection, to 0.42 (Snellen equivalent ~20/50) (<i>P</i> < .001), 0.43 (Snellen equivalent ~20/50) (<i>P</i> < .001), and 0.45 (Snellen equivalent ~20/60) (<i>P</i> = .70) at the second, third, and fourth intravitreal aflibercept 8 mg injections, respectively. Treatment intervals to time of second, third, and fourth intravitreal aflibercept 8 mg injections increased compared to baseline intervals, by a mean of 2.2 days (<i>P</i> < .001), 2.5 days (<i>P</i> < .001), and 13.5 days (<i>P</i> < .001), respectively. Intraocular inflammation was observed in 11 eyes (1 in 1853 injections). Nine eyes (1 in 2265 injections) developed suspected endophthalmitis. <b>Conclusions:</b> In this real-world clinical setting, intravitreal aflibercept 8 mg treatment demonstrated improvements in BCVA outcomes, with increased intervals between injections. Rates of intraocular inflammation and endophthalmitis were low.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251383384"},"PeriodicalIF":0.8,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145346234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Intravitreal Pegcetacoplan vs Avacincaptad Pegol in Patients With Geographic Atrophy.","authors":"Paul Hahn, David Eichenbaum, Dilsher S Dhoot, Charles C Wykoff, Michael A Klufas, Michele Intorcia, Daniel Jones, Sujata P Sarda, Priyanka Bobbili, Rose Chang, Maryaline Catillon, Chunyi Xu, Kirthana Sarathy, Mei Sheng Duh, Caroline R Baumal, Varun Chaudhary","doi":"10.1177/24741264251379842","DOIUrl":"10.1177/24741264251379842","url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the efficacy of intravitreal (IVT) pegcetacoplan monthly vs avacincaptad pegol monthly (primary analysis), and pegcetacoplan every other month vs avacincaptad pegol monthly (secondary analysis), for geographic atrophy (GA). <b>Methods:</b> Matching-adjusted indirect comparisons (MAIC) were conducted across global phase 3 trials using individual patient data from 2 pegcetacoplan trials (OAKS, NCT03525613; DERBY, NCT03525600) and published aggregate data from the avacincaptad pegol GATHER2 trial (NCT04435366). GATHER2 inclusion and exclusion criteria were applied to the OAKS and DERBY individual patient data. Key baseline variables were balanced using propensity score weighting. GA lesion growth at month 12 was assessed. Results from the MAIC were combined using meta-analysis. <b>Results:</b> The primary analysis included 103 patients from OAKS and 102 patients from DERBY who met the GATHER2 inclusion and exclusion criteria, and 447 patients from GATHER2. In OAKS vs GATHER2, the adjusted difference in GA lesion growth at month 12 between pegcetacoplan monthly and avacincaptad pegol was -0.716 mm² (95% CI, -1.385 to -0.046; <i>P</i> = .04), statistically favoring pegcetacoplan monthly. In DERBY vs GATHER2, the adjusted difference was -0.234 mm² (95% CI, -1.354 to 0.885; <i>P</i> = .68), directionally favoring pegcetacoplan monthly. After meta-analysis, the pooled effect for pegcetacoplan monthly vs avacincaptad pegol was -0.589 mm² (95% CI, -1.164 to -0.014; <i>P</i> = 0.04), statistically favoring pegcetacoplan monthly. A numerically greater reduction in GA lesion growth was observed with pegcetacoplan every other month vs avacincaptad pegol monthly (95% CI, -1.130 to -0.300; <i>P</i> = .25). <b>Conclusions:</b> Matching-adjusted indirect comparisons support a greater reduction in GA growth with pegcetacoplan monthly vs avacincaptad pegol monthly and no significant difference between pegcetacoplan every other month and avacincaptad pegol monthly.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251379842"},"PeriodicalIF":0.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal Detachment in the Setting of Neurofibromatosis Type 1.","authors":"Lauren Pickel, Miguel Cruz Pimentel, Anarsaikhan Narmandakh, Austin Pereira, Peng Yan","doi":"10.1177/24741264251374596","DOIUrl":"10.1177/24741264251374596","url":null,"abstract":"<p><p><b>Purpose:</b> Neurofibromatosis type 1 (NF1) is a multisystem neurocutaneous syndrome that includes ocular manifestations. This systematic literature review aimed to examine evidence of an association between NF1 and retinal detachment (RD). <b>Methods:</b> Ovid MEDLINE, EMBASE, and PubMed were searched from database inception to February 2024 for reports of RD related to NF1. An additional case of spontaneous RD in a young patient with NF1 is reported. <b>Results:</b> In total, 27 reported cases of NF1-associated RD were identified, of which 14 were associated with intraocular or intraorbital space-occupying lesions. Lesion-associated RDs were exudative and presented in patients at a median age of 19.6 years (range 10 to 36 years). The remaining 13 cases, and the novel case reported herein of a patient with RD secondary to a giant retinal tear, were spontaneous rhegmatogenous RD, presenting in patients at a median age of 19.1 years (range 22 months to 49 years). The most common presentation of spontaneous RD was an asymptomatic finding on routine exam (55% of reported cases). <b>Conclusions:</b> NF1 may increase the risk of RD through 2 mechanisms: exudation caused by space-occupying intraorbital lesions, or rhegmatogenous RD resulting from irregularities in vitreoretinal adhesion due to abnormal collagen production. While further evidence is needed, extended ocular screening of patients with NF1 into adulthood may be considered.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251374596"},"PeriodicalIF":0.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Effects of Smoking on Retinal and Choriocapillaris Perfusion: An Optical Coherence Tomography Angiography Study.","authors":"Erdem Dursun, Merve Inanc, Ali Mert Kocer, Adife Gamze Akyuz Dursun, Kemal Tekin","doi":"10.1177/24741264251383398","DOIUrl":"10.1177/24741264251383398","url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the long-term effects of smoking on retinal microcirculation and choriocapillaris flow, and to compare microvascular alterations between healthy smokers and nonsmokers using optical coherence tomography (OCT) angiography. <b>Methods:</b> A total of 160 patients (86 smokers, 74 nonsmokers) were enrolled in this prospective, cross-sectional study. Non-flow and foveal avascular zone (FAZ) parameters, vessel density parameters of the macula and optic disc, and choriocapillaris flow area were obtained using OCT angiography. <b>Results:</b> The mean FAZ area in the whole retina and FAZ perimeter were significantly larger in the smoker group compared with the nonsmoker group (<i>P</i> = .003 and <i>P</i> = .002, respectively). Significant differences were also observed in vessel density of the superficial and deep capillary plexus, except in some zones of superficial perifovea, deep perifovea, and deep parafovea. No significant differences were found in vascular density of the optic disc region between groups (<i>P</i> > .05) The choriocapillaris flow within the 3 mm radius area was lower in smokers than in nonsmokers (<i>P</i> < .05). <b>Conclusions:</b> Cigarette smoking was associated with reduced retinal and choroidal vascularity as measured by OCT angiography. These findings support a potential detrimental role of smoking in the development of ocular diseases.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251383398"},"PeriodicalIF":0.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12534829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Panuveitis Associated With Idiopathic Hypereosinophilic Syndrome.","authors":"Raquel Burggraaf-Sánchez de Las Matas, Marta Garijo-Bufort, Bárbara Juan-Ribelles, Véronique Benavent-Corai, Miguel Ortiz-Salvador, María Teresa Gimeno-Brosel","doi":"10.1177/24741264251366415","DOIUrl":"10.1177/24741264251366415","url":null,"abstract":"<p><p><b>Purpose:</b> To describe a patient with idiopathic hypereosinophilic syndrome (HES) associated with panuveitis. <b>Methods</b>: An interventional case report is presented. <b>Results:</b> A 70-year-old woman presented with intermittent cutaneous eruptions, bilateral panuveitis, and a ground-glass pattern on chest CT-scan, with isolated eosinophilia of 12.8 × 10⁹/L. A complete uveitis workup was performed, and the patient was evaluated to rule out secondary causes of eosinophilia, with a thorough focus on infections, eosinophilic granulomatosis with polyangiitis, sarcoidosis, and drug-related syndromes. A bone marrow biopsy ruled out primary eosinophilia. Cytogenetics were also negative. Under steroid treatment there was no recurrence of skin rashes and panuveitis was satisfactorily resolved, but further use of mepolizumab was needed to normalize the hemogram. <b>Conclusions:</b> The diagnosis of HES requires a comprehensive evaluation. Ocular involvement is rare. We present the ocular findings during the acute stage for the first time, along with the current management approach.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251366415"},"PeriodicalIF":0.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swept-Source Optical Coherence Tomography Angiography After Rhegmatogenous Retinal Detachment Treated With Different Approaches.","authors":"Zofia Nawrocka, Jerzy Nawrocki","doi":"10.1177/24741264251381976","DOIUrl":"10.1177/24741264251381976","url":null,"abstract":"<p><p><b>Purpose:</b> To present long-term changes in swept-source optical coherence tomography angiography (SS-OCTA) after different approaches in rhegmatogenous retinal detachment. <b>Methods:</b> This was a retrospective study of patients after segmental buckling, circumferential buckling, primary vitrectomy, or combined surgery (vitrectomy and scleral buckling) in whom SS-OCTA was performed at 1 month and 24 months after surgery. Central retinal thickness, central choroidal thickness visual acuity, macula-on vs macula-off status, vascular density, and fovea avascular zones (FAZs) in superficial and deep vascular retinal layers were analyzed. <b>Results:</b> We included 150 eyes of 150 patients. Final visual acuity was better in macula-on vs macula-off cases (<i>P</i> < .05). In comparison with the fellow eyes, final central choroidal thickness was lower in macula-off retinal detachments (<i>P</i> = .042). Deep vessel density was also lower in macula-off eyes when compared with their fellow eyes, which was of high significance in lower quadrants (<i>P</i> = .008). Patients after primary vitrectomy had lower deep FAZ, superficial vessel density, and deep vessel density when compared with eyes after circumferential and segmental buckling (<i>P</i> = .005, <i>P</i> = .037, and <i>P</i> < .001, respectively). After segmental and circumferential buckling, deep vessel density increased between the first and last follow-up visits (<i>P</i> = .018). After primary vitrectomy, no improvements in deep vessel densities after surgery were observed. Macular edema was observed in 13 eyes during the observation period. Multiple variate analysis revealed that the only factor responsible for later occurrence of macular edema was low deep vessel density 1 month after surgery. <b>Conclusion:</b> Segmental buckling does not affect vasculature when visualized with SS-OCTA. Long-term changes observed after circumferential buckling were less pronounced than after primary vitrectomy or combined procedures using perfluorocarbon liquid, silicone oil, and internal limiting membrane peeling. Macula-off patients had a lower postoperative vessel density, correlating with the development of macular edema and decreased final vision.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251381976"},"PeriodicalIF":0.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paracentral Acute Middle Maculopathy After Sinus Surgery: A Case Report and Literature Review.","authors":"Muhi Dean Barazi, Mohsin Ali, Omar Belal Sabbagh, Abdullah Abou-Samra, Jared Ebert, Isabel Eaddy, Jeanette Du","doi":"10.1177/24741264251366410","DOIUrl":"10.1177/24741264251366410","url":null,"abstract":"<p><p><b>Purpose:</b> Herein, we describe a case of paracentral acute middle maculopathy occurring after routine sinus surgery. <b>Methods:</b> A single case was evaluated. <b>Results</b>: The patient presented with an inferocentral scotoma in the left eye 2 days after an uneventful sinuplasty procedure performed under local anesthesia. Examination and optical coherence tomography demonstrated paracentral acute middle maculopathy. A complete workup and urgent stroke evaluation revealed no clear underlying etiology. <b>Conclusion</b>: Sinus procedures may rarely be associated with paracentral acute middle maculopathy, possibly due to the vasoconstrictive effects of local anesthetics. Ophthalmologists and head and neck surgeons should be aware of this potential complication.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251366410"},"PeriodicalIF":0.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Neovascular Age-Related Macular Degeneration Outcomes in Established vs New Patients of a Retina Practice.","authors":"Jeanette Du, Mike Y Chen, Rohini Dasan, Allison Chen, Geena Kim, Abhishek Naidu, Jared Ebert, Jason M Huang, Joshua D Levinson, Mohsin H Ali, Brian K Do","doi":"10.1177/24741264251374576","DOIUrl":"10.1177/24741264251374576","url":null,"abstract":"<p><p><b>Purpose:</b> To compare the treatment outcomes of newly diagnosed unilateral neovascular age-related macular degeneration (nAMD) in established patients of a retina practice with those of patients referred by non-retina specialist providers. <b>Methods:</b> This is a retrospective cohort study of patients with unilateral nAMD treated with intravitreal antivascular endothelial growth factor (anti-VEGF) therapy and at least 12 months of follow-up. Group 1 included established patients with initially bilateral dry age-related macular degeneration (AMD) that subsequently converted to unilateral nAMD requiring anti-VEGF treatment. Group 2 patients were referred to the practice with newly diagnosed unilateral nAMD requiring anti-VEGF treatment. All included patients presented with cases of new neovascular disease of the first eye. <b>Results:</b> There were 253 patients in Group 1 and 392 in Group 2. Average logMAR (Snellen equivalent) best-corrected visual acuity (BCVA) at time of neovascular conversion was 0.40 (20/50) for Group 1 and 0.62 (20/80) for Group 2 (<i>P</i> < .001). The percentage of patients with submacular hemorrhage was 7.9% for Group 1 and 18.6% for Group 2 (<i>P</i> < .001). By 12 months, BCVA improved to 0.36 (20/40) for Group 1 and 0.52 (20/60) for Group 2 (<i>P</i> < .001). The mean ± SD number of injections in the first 12 months of therapy was 8.64 ± 2.17 for Group 1 and 9.19 ± 2.33 for Group 2 (<i>P</i> = .003). <b>Conclusions:</b> Visual outcomes were superior in established patients of retina specialists at the time of nAMD conversion in the first eye. It may be advantageous for patients with dry AMD to already be under the care of a retina specialist at the time of neovascular conversion.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251374576"},"PeriodicalIF":0.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes and Patient Experiences With the Argus II Retinal Prosthesis System.","authors":"Jonathan D Shirian, Alex Yuan, Aleksandra Rachitskaya","doi":"10.1177/24741264251376042","DOIUrl":"10.1177/24741264251376042","url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the long-term outcomes and experiences of patients with the Argus II retinal prosthesis in individuals with advanced-stage retinitis pigmentosa. <b>Methods:</b> Chart review was conducted on 13 patients with the Argus II implant between June 2015 and February 2018 at the Cleveland Clinic Cole Eye Institute. Data collected included examination findings, adverse events, device usage, impact on quality of life, and patient satisfaction. <b>Results:</b> The average age of patients at implantation was 71 years, with 84.6% being male. All patients had severe visual impairment prior to surgery. Four patients experienced serious adverse events, including conjunctival erosion, vitreous hemorrhage, persistent corneal abrasion, and vertigo. None of the 10 patients who had recent follow-up appointments were currently using the device, with an average ± SD usage duration of 3.34 ± 2.65 years. Discontinuation reasons included performance issues, cognitive load, and physical discomfort, among others. Five patients reported that with the knowledge they currently have, they would choose to receive the implant again. <b>Conclusions:</b> Argus II provided potential benefits but also presented significant challenges related to device performance, cognitive demands, and long-term support. The cessation of commercial operations by the manufacturer and the resulting lack of support further complicated the experiences of patients. Despite this, the device remains a pioneering step in retinitis pigmentosa treatment, underscoring the need for ongoing innovation in visual prosthesis technology.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251376042"},"PeriodicalIF":0.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Functional and Anatomic Outcomes With Aflibercept 8.0 mg in Patients With Diabetic Macular Edema.","authors":"Gabriel Castilho S Barbosa, Suraj Bala, Nitesh Mohan, Sunil K Srivastava, Peter K Kaiser, Ananth Sastry, Amy S Babiuch, Jonathan Sears, Katherine E Talcott, Alex Yuan, Aleksandra Rachitskaya, Justis P Ehlers, Andrew P Schachat, Phoebe Lin, Sumit Sharma, Danny A Mammo","doi":"10.1177/24741264251376918","DOIUrl":"10.1177/24741264251376918","url":null,"abstract":"<p><p><b>Purpose:</b> To assess clinical outcomes in diabetic macular edema (DME) patients treated with high-dose aflibercept 8.0 mg (HDA), focusing on treatment intervals, anatomic changes, and best-corrected visual acuity (BCVA). <b>Methods:</b> This retrospective, single-center study included 67 DME patients (100 eyes) treated at Cole Eye Institute between August 2023 and November 2024. All patients received at least 3 HDA injections, with a true loading dose defined as 3 initial injections given ≤ 5 weeks apart. The primary outcome was proportion of eyes for which minimum ≥ 7-week treatment intervals were maintained. Secondary outcomes included changes in BCVA, central subfield thickness (CST), and macular fluid status. <b>Results:</b> Loading dose was completed in 73 eyes (73%) and not completed in 27 eyes (27%). Before HDA injections, 4.0% of eyes were anti-vascular endothelial growth factor naive. Mean (±SD) follow-up was 24.3 ± 5.0 weeks. From baseline to final visit, mean (±SD) CST significantly decreased (from 371.1 ± 134.6 μm to 330.0 ± 121.7 μm; <i>P</i> = .025), while BCVA remained stable (from 62.4 ± 18.8 to 63.5 ± 17.7 ETDRS letters; <i>P</i> = .676). For 32 eyes (32%), ≥ 7-week treatment intervals could not be maintained, with 18 eyes being switched to alternative therapy and 14 eyes requiring < 7-week injection intervals; these eyes had significantly higher baseline CST (<i>P</i> = .045). Persistent macular fluid was observed in 90% of eyes. <b>Conclusion:</b> HDA reduced CST and stabilized BCVA in DME patients. However, remaining challenges include frequent injections and persistent macular fluid, underscoring the chronic, treatment-resistant nature of DME and need for optimized treatment strategies.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251376918"},"PeriodicalIF":0.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}