title: Comparison between ranibizumab and aflibercept for macular edema associated with central retinal vein occlusion.
abstract: OBJECTIVE
  We compared the efficacy of bimonthly intravitreal injections of ranibizumab (IVR) with that of bimonthly intravitreal injections of aflibercept (IVA) in two prospective, consecutive groups of patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO).
  
  
  METHODS
  Eyes with ME after CRVO received either bimonthly IVR (ranibizumab group; n = 13) or IVA (aflibercept group; n = 13) injections and were followed monthly for 6 months. Three patients in the ranibizumab group and two in the aflibercept group were lost to follow-up and excluded from the study. The best-corrected visual acuity (BCVA), central foveal thickness (CFT) on optical coherence tomography, and aqueous vascular endothelial growth factor (VEGF) concentrations were evaluated before and after treatment.
  
  
  RESULTS
  From baseline to month 6, significant improvements occurred in mean logMAR BCVA (ranibizumab group: 0.78-0.47; p < 0.05; aflibercept group: 0.74-0.54; p < 0.05) and mean CFT (ranibizumab group: 685-311 µm; p < 0.05; aflibercept group: 695-230 µm; p < 0.05). Fluctuations in CFT were seen at months 2, 4, and 6 in the ranibizumab group. Mean aqueous VEGF concentration decreased from baseline to month 2 in the ranibizumab group (509.9-348.2 pg/ml) and aflibercept group (412.1 pg/ml to undetectable limits in eight of 11 eyes and to 13.6, 15.6, and 24.1 pg/ml in the other three eyes, respectively).
  
  
  CONCLUSIONS
  There was no significant improvement of visual acuity in one group compared with another; VEGF may not be completely neutralized by bimonthly injections of ranibizumab.
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta-Tsukinowacho, Otsu, Shiga, 520-2192, Japan. saishin@belle.shiga-med.ac.jp.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Saishin
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta-Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta-Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujikawa
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta-Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Sawada
authors.affiliation: Department of Ophthalmology, Shiga University of Medical Science, Seta-Tsukinowacho, Otsu, Shiga, 520-2192, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Ohji
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069579:Ranibizumab / Q000008:administration & dosage*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D012160:Retina / Q000000981:diagnostic imaging*; D012170:Retinal Vein Occlusion / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab
keywords: Aflibercept; Bimonthly intravitreal injection; Central retinal vein occlusion; Macular edema; Ranibizumab