Aflibercept shows potential in preventing vision loss in radiation retinopathy

Intravitreal aflibercept injections (IAIs) may improve central retinal thickness (CRT) and potentially prevent vision loss in patients with radiation retinopathy (RR)-related macular edema when administered using a treat-and-extend regimen for 52 weeks, according to a study.

In the multicenter, prospective, randomized clinical trial, the effectiveness of 2 mg IAIs for the treatment of RR was evaluated. A total of 39 patients with RR-related macular edema causing vision loss were randomly assigned to receive a loading dose of 3 IAIs followed by a treat-and-extend regimen or no loading dose.

After one year, 30 out of the 39 patients (76.9%) completed the follow-up visit. The overall mean BCVA change from baseline was 4.3 letters, although this difference was not statistically significant.

In the cohort that received the loading dose and treat-and-extend regimen, there was a greater mean BCVA improvement of 6.69 letters, compared to the 1.57 letters gained by the cohort that did not receive a loading dose. However, this difference was also not statistically significant.

A significant difference in CRT from baseline to week 52 was found. The overall CRT decreased from 484.4 µm to 326.5 µm, and both cohorts exhibited similar reductions in CRT: the cohort with no loading dose decreased from 441.2 µm to 311.1 µm, while the cohort with the loading dose decreased from 522.3 µm to 339.9 µm.

In addition, 96.7% of the patients achieved a visual acuity of 20/200 or better, and 30.0% experienced an improvement of  ≥10 letters.

Reference
Trejo Corona S, Villanueva Boone C, Ali AM, et al; ARRT Study Group. Randomized Trial of Treat-and-Extend Intravitreal Aflibercept for Radiation Retinopathy: 1-Year Outcomes. Invest Ophthalmol Vis Sci. 2023;64(7):35. doi: 10.1167/iovs.64.7.35. PMID: 37351877.