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Ranibizumab (Lucentis) vs Aflibercept (Eyelea) for the treatment of neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DMO) and retinal vein occlusion (RVO) in rural clinical practice

Naomi Clements, Michelle Hui, Brent Skippen

Purpose

To compare results of Ranibizumab vs Aflibercept for the treatment of nAMD, DMO and RVO and ascertain variations in clinical outcomes in a rural setting.

Methods

Retrospective observational cohort study assessing 106 eyes from 84 patients over 18 months. Primary outcome measures are anatomical (central macular thickness - CMT) and functional (visual acuity - VA), secondary outcomes include number of injections and overall safety profile. Statistical analyses (repeated measure ANOVA, chi-square analysis and Bonferroni post-hoc test) conducted with SPSS. Significance level set at p<.10

Results

For nAMD, VA and CMT results were comparable between Ranibizumab and Aflibercept. More ‘dry’ OCT outcomes occurred with Ranibizumab. Similar VA and CMT results occurred with DMO treatment, except for significantly more ‘dry’ OCT outcomes with Aflibercept in those DMO patients with prior injections. For RVO patients, while anatomical results were comparable, VA improved significantly with Ranibizumab, not Aflibercept. More ‘dry’ OCT outcomes were achieved with Ranibizumab.

Demographic analysis showed a mean age of 76 years, 57.5% female. Overall average of 7 injections in 12 months. One serious adverse event was recorded (myocardial infarction) with Ranibizumab for nAMD.

Discussion

There were no significant differences in functional or anatomical outcomes between Ranibizumab and Aflibercept for treatment of nAMD and DMO. Ranibizumab showed statistically significant improvement in outcomes over Aflibercept in treatment of RVO. To the best of our knowledge, this study is the first of its kind in a rural Australian setting

November, 2020
10.37912/WaggaJOM.0201.12

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