Abstract
Purpose: Assess associations of 2-year visual acuity (VA) outcomes with VA and optical coherence tomography central subfield thickness (CST) after 12 weeks of anti–vascular endothelial growth factor treatment for diabetic macular edema in DRCR.net Protocol T. Design: Randomized clinical trial. Methods: SETTING: Multicenter (89 U.S. sites). PATIENT POPULATION: Eyes with VA and CST data from baseline and 12-week visits (616 of 660 eyes randomized [93.3%]). INTERVENTION: Six monthly injections of 2.0 mg aflibercept, 1.25 mg bevacizumab, or 0.3 mg ranibizumab; subsequent injections and focal/grid laser as needed for stability. MAIN OUTCOME MEASURES: Change in VA from baseline and VA letter score at 2 years. Results: Twelve-week VA response was associated with 2-year change in VA and 2-year VA letter score for each drug (P <.001) but with substantial individual variability (multivariable R2 = 0.38, 0.29, and 0.26 for 2-year change with aflibercept, bevacizumab, and ranibizumab, respectively). Among eyes with less than 5-letter gain at 12 weeks, the percentages of eyes gaining 10 or more letters from baseline at 2 years were 42% (20 of 48), 31% (21 of 68), and 47% (28 of 59), and median 2-year VA was 20/32, 20/32, and 20/25, in the aflibercept, bevacizumab, and ranibizumab groups, respectively. Twelve-week CST response was not strongly associated with 2-year outcomes. Conclusions: A suboptimal response at 12 weeks did not preclude meaningful vision improvement (ie, ≥ 10-letter gain) in many eyes at 2 years. Eyes with less than 5-letter gain at 12 weeks often had good VA at 2 years without switching therapies.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 93-100 |
| Number of pages | 8 |
| Journal | American Journal of Ophthalmology |
| Volume | 195 |
| DOIs | |
| State | Published - Nov 1 2018 |
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ASJC Scopus subject areas
- Ophthalmology
Cite this
Early Response to Anti–Vascular Endothelial Growth Factor and Two-Year Outcomes Among Eyes With Diabetic Macular Edema in Protocol T . / Diabetic Retinopathy Clinical Research Network.
In: American Journal of Ophthalmology, Vol. 195, 01.11.2018, p. 93-100.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Early Response to Anti–Vascular Endothelial Growth Factor and Two-Year Outcomes Among Eyes With Diabetic Macular Edema in Protocol T
AU - Diabetic Retinopathy Clinical Research Network
AU - Bressler, Neil M
AU - Beaulieu, Wesley T.
AU - Maguire, Maureen G.
AU - Glassman, Adam R.
AU - Blinder, Kevin J.
AU - Bressler, Susan B
AU - Gonzalez, Victor H.
AU - Jampol, Lee M.
AU - Melia, Michele
AU - Sun, Jennifer K.
AU - Wells, John A.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Purpose: Assess associations of 2-year visual acuity (VA) outcomes with VA and optical coherence tomography central subfield thickness (CST) after 12 weeks of anti–vascular endothelial growth factor treatment for diabetic macular edema in DRCR.net Protocol T. Design: Randomized clinical trial. Methods: SETTING: Multicenter (89 U.S. sites). PATIENT POPULATION: Eyes with VA and CST data from baseline and 12-week visits (616 of 660 eyes randomized [93.3%]). INTERVENTION: Six monthly injections of 2.0 mg aflibercept, 1.25 mg bevacizumab, or 0.3 mg ranibizumab; subsequent injections and focal/grid laser as needed for stability. MAIN OUTCOME MEASURES: Change in VA from baseline and VA letter score at 2 years. Results: Twelve-week VA response was associated with 2-year change in VA and 2-year VA letter score for each drug (P <.001) but with substantial individual variability (multivariable R2 = 0.38, 0.29, and 0.26 for 2-year change with aflibercept, bevacizumab, and ranibizumab, respectively). Among eyes with less than 5-letter gain at 12 weeks, the percentages of eyes gaining 10 or more letters from baseline at 2 years were 42% (20 of 48), 31% (21 of 68), and 47% (28 of 59), and median 2-year VA was 20/32, 20/32, and 20/25, in the aflibercept, bevacizumab, and ranibizumab groups, respectively. Twelve-week CST response was not strongly associated with 2-year outcomes. Conclusions: A suboptimal response at 12 weeks did not preclude meaningful vision improvement (ie, ≥ 10-letter gain) in many eyes at 2 years. Eyes with less than 5-letter gain at 12 weeks often had good VA at 2 years without switching therapies.
AB - Purpose: Assess associations of 2-year visual acuity (VA) outcomes with VA and optical coherence tomography central subfield thickness (CST) after 12 weeks of anti–vascular endothelial growth factor treatment for diabetic macular edema in DRCR.net Protocol T. Design: Randomized clinical trial. Methods: SETTING: Multicenter (89 U.S. sites). PATIENT POPULATION: Eyes with VA and CST data from baseline and 12-week visits (616 of 660 eyes randomized [93.3%]). INTERVENTION: Six monthly injections of 2.0 mg aflibercept, 1.25 mg bevacizumab, or 0.3 mg ranibizumab; subsequent injections and focal/grid laser as needed for stability. MAIN OUTCOME MEASURES: Change in VA from baseline and VA letter score at 2 years. Results: Twelve-week VA response was associated with 2-year change in VA and 2-year VA letter score for each drug (P <.001) but with substantial individual variability (multivariable R2 = 0.38, 0.29, and 0.26 for 2-year change with aflibercept, bevacizumab, and ranibizumab, respectively). Among eyes with less than 5-letter gain at 12 weeks, the percentages of eyes gaining 10 or more letters from baseline at 2 years were 42% (20 of 48), 31% (21 of 68), and 47% (28 of 59), and median 2-year VA was 20/32, 20/32, and 20/25, in the aflibercept, bevacizumab, and ranibizumab groups, respectively. Twelve-week CST response was not strongly associated with 2-year outcomes. Conclusions: A suboptimal response at 12 weeks did not preclude meaningful vision improvement (ie, ≥ 10-letter gain) in many eyes at 2 years. Eyes with less than 5-letter gain at 12 weeks often had good VA at 2 years without switching therapies.
UR - http://www.scopus.com/inward/record.url?scp=85052868070&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052868070&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2018.07.030
DO - 10.1016/j.ajo.2018.07.030
M3 - Article
C2 - 30077569
AN - SCOPUS:85052868070
VL - 195
SP - 93
EP - 100
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -