Short-tern efficacy of conbercept versus ranibizumab for macular edema in central retinal vein occlusion_Chinese Journal of Ocular Fundus Diseases

Authors：

LianHaiyan ,  SongYanping , DingQin , ChenZhongshan

Department of Ophthalmology, Wuhan Genenal Hospital of Guangzhou Military, Wuhan 430070, China;

Corresponding author：

SongYanping, Email: songyanping@medmail.com.cn

Keywords：

Retinal vein occlusion/drug therapy; Macular edema/drug therapy; Angiogenesis inhibitors/therapeutic use; Antibodies,monoclonal/therapeutic use; Tomography,optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2016.006

Video：

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Objective To compare the short-term efficacy of conbercept and ranibizumab for macular edema in central retinal vein occlusion (CRVO)and explore the relationship between the integrity of ellipsoidal zone and visual acuity. Methods Forty-four eyes of 44 patients with macular edema in CRVO were enrolled into this retrospective and comparative study. There were 15 eyes of 15 males, 29 eyes of 29 females; age ranged from 49-61 years old,with an average age of (54.65±3.10) years. All patients were examined with best-corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp, fundus photograph, fundus fluorescein angiography (FFA), optical coherence tomography(OCT). BCVA were examined with interactional visual chart and recorded with logarithm of the minimum angle of resolution acuity. Twenty-three eyes were intravitreal injected with conbercept 0.5 mg (group A) and 21 eyes were intravitreal injected with ranibizumab 0.5 mg (group B). There was no statistical difference of age (t=-1.41), gender (χ²= 0.55),the percentage of hypertension patients (χ²=0.27), average BCVA (t=-2.06), IOP (t=-2.52), central macular thickness (CMT) (t=-1.96), number of different integrity of ellipsoidal zone patients (χ²=1.00) and number of different types of macular edema patients (χ²=1.03) among the two groups (P > 0.05). The change in BCVA and CMT at 3, 6 months between the two groups were compared. The relationship between BCVA at 6 months and BCVA, CMT at baseline were explored. The relationship between three groups of ellipsoidal zone and BCVA at baseline were evaluated. The change of BCVA after treatment between the three groups of ellipsoidal zone were Compared. The number of intravitreal injections between two groups was compared. Results During the 3, 6 months after treatment, the mean BCVA were all improved with statistically difference in group A (t=5.13, 7.39; P < 0.05) and group B (t=6.60, 11.52; P < 0.05). There was no significant difference of BCVA at 3, 6 moths between group A and group B (t=-0.99, -0.40; P > 0.05). During the 3, 6 months after treatment, the mean CMT were all decreased with statistically difference in group A (t=11.58, 15.96; P < 0.05) and group B (t=18.77, 35.16; P < 0.05). There was no significant difference of CMT at 3, 6 months between group A and group B (t=-1.52, -1.63; P > 0.05). In both groups,BCVA at 6 months was related to BCVA at baseline (r= 0.44, 0.62; P < 0.05), but not related to CMT at baseline (r=0.19, 0.01; P > 0.05). In the two groups, BCVA at baseline was related to the integrity of ellipsoidal zone (r=0.97, 0.70; P < 0.05). There was statistical difference of the number of intravitreal injections in the two groups (t=-6.88, P < 0.05). There was no systemic or ocular serious side effects during the follow up. Conclusions Comparing to ranibizumab, conbercept has the same effective to the treatment of macular edema in CRVO, but the number of intravitreal injections is less. The integrity of ellipsoidal zone is related to BCVA.

Citation： LianHaiyan, SongYanping, DingQin, ChenZhongshan. Short-tern efficacy of conbercept versus ranibizumab for macular edema in central retinal vein occlusion. Chinese Journal of Ocular Fundus Diseases, 2016, 32(4): 367-371. doi: 10.3760/cma.j.issn.1005-1015.2016.006 Copy

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11.	Rosenfeld PJ, Brown DM, Heier JS,et al.Ranibizumab for neovascular age-related macular degeneration[J].N Engl J Med,2006,355(14):1419-1431.
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13.	Brown DM, Campochiaro PA, Bhisitkul RB,et al.Sustained benefits from ranibizumab for macular edema following branch retinal vein occlusion:12-month outcomes of a phase Ⅲ study[J].Ophthalmology,2011,118(8):1594-1602. DOI:10.1016/j.ophtha.2011.02.022.
14.	Campochiaro PA, Sophie R, Pearlman J,et al.Long-term outcomes in patients with retinal vein occlusion treated with ranibizumab:the RETAIN study[J].Ophthalmology, 2014,121(1):209-219. DOI:10.1016/j.ophtha.2013.08.038.
15.	Karia N. Retinal vein occlusion:pathophysiology and treatment options[J]. Clin Ophthalmol,2010,4:809-816.
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19.	Oishi A,Shimozono M,Mandai M,et al.Recovery of photoreceptor outer segments after anti-VEGF therapy for agerelated macular degeneration[J]. Graefe's Arch Clin Exp Ophthalmol,2013,251(2):435-440.DOI:10.1007/s00417-012-2034-4.
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1. Meyer CH, Holz FG. Preclinical aspects of anti-VEGF agents for the treatment of wet AMD:ranibizumab and bevacizumab[J]. Eye, 2011, 25(6):661-672.DOI:10.1038/eye.2011.66.
2. Noma H, Funatsu H, Mimura T, et al. Vitreous levels of interleukin-6 and vascular endothelial growth factor in macular edema with central retinal vein occlusion[J]. Ophthalmology,2009,116(1):87-93.DOI:10.1016/j.ophtha.2008.09.034.
3. Hidetaka N, Hideharu F, Makiko Y, et al. Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6[J]. Am J Ophthalmol, 2005, 140(2):256-261.
4. Turgut B,Tanyildizi R. The frequency of the nonresponsiveness to intravitreal injection of the anti-vascular endothelial growth factor agent in neovascular age related macular degeneration[J/OL]. Int J Ophthalmic Pathol, 2013,2:3[2013-05-17]. http//dxdoi.org/10.4172/2324-8599.1000119. DOI:10.4172/2324-8599.1000119.
5. Iturralde D,Spaide RF,Meyerle CB,et al.Intravitreal bevacizumab(Avastin) treatment of macular edema in central retinal vein occlusion:a short-term study[J]. Retina,2006,26(3):279-284.
6. Figueroa MS,Contreras I,Noval S,et al. Results of bevacizumab as the primary treatmen for retinal vein occlusion[J]. Br J Ophthalmol,2010,94(8):1052-1056. DOI:10.1136/bjo.2009.173732.
7. Zhang M, Yu D, Yang C, et al. The pharmacology study of a new recom-binant human VEGF receptor-fc fusion protein on experimental choroidal neovascularization[J]. Pharm Res, 2009, 26(1):204-210. DOI:10.1007/s11095-008-9718-9.
8. Li X, Xu G, Wang Y, et al. Safety and efficacy of conbercept in neovascular age-related macular degeneration:results from a 12-month randomized phase 2 study:AURORA study[J]. Ophthalmology,2014,121(9):1740-1747.DOI:10.1016/j.ophtha.2014.03.026.
9. 薛康, 姜春晖, 徐格致,等. 视网膜静脉阻塞黄斑水肿的光相干断层扫描观察[J]. 中华眼底病杂志,2011, 27(2):127-131.DOI:10.3760/cma.j.issn.1005-1015.2011.02.005. Xue K,Jiang CH,Xu GZ,et al.Optical coherence tomography of macular edema in retinal vein occlusion[J].Chin J Ocul Fundus Dis,2011, 27(2):127-131.DOI:10.3760/cma.j.issn.1005-1015.2011.02.005.
10. Campochiaro PA, Brown DM, Awh CC,et al.Sustained benefits from ranibizumab for macular edema following central retinal vein occlusion:twelve-month outcomes of a phase Ⅲ study[J].Ophthalmology, 2011,118(10):2041-2049. DOI:10.1016/j.ophtha.2011.02.038.
11. Rosenfeld PJ, Brown DM, Heier JS,et al.Ranibizumab for neovascular age-related macular degeneration[J].N Engl J Med,2006,355(14):1419-1431.
12. Brown DM, Kaiser PK, Michels M,et al.Ranibizumab versus verteporfin for neovascular age-related macular degeneration[J].N Engl J Med,2006,355(14):1432-1444.
13. Brown DM, Campochiaro PA, Bhisitkul RB,et al.Sustained benefits from ranibizumab for macular edema following branch retinal vein occlusion:12-month outcomes of a phase Ⅲ study[J].Ophthalmology,2011,118(8):1594-1602. DOI:10.1016/j.ophtha.2011.02.022.
14. Campochiaro PA, Sophie R, Pearlman J,et al.Long-term outcomes in patients with retinal vein occlusion treated with ranibizumab:the RETAIN study[J].Ophthalmology, 2014,121(1):209-219. DOI:10.1016/j.ophtha.2013.08.038.
15. Karia N. Retinal vein occlusion:pathophysiology and treatment options[J]. Clin Ophthalmol,2010,4:809-816.
16. Matsumoto Y, Freund KB, Peiretti E, et al. Rebound macular edema following bevacizumab (Avastin) therapy for retinal venous occlusive disease[J]. Retina, 2007, 27(4):426-431.
17. Yamashiro K, Tsujikawa A, Ota M. Association between foveal photoreceptor integrity and visual outcome in neovascular age-related macular degeneration[J]. Am J Ophthalmol,2009,148(148):83-89.DOI:10.1016/j.ajo.2009.01.017.
18. Murakami T, Tsujikawa A, Ohta M, et al. Photoreceptor status after resolved macular edema in branch retinal vein occlusion treated with tissue plasminogen activator[J]. Am J Ophthalmol,2007, 143(1):171-173.DOI:10.1016/j.ajo.2006.08.030.
19. Oishi A,Shimozono M,Mandai M,et al.Recovery of photoreceptor outer segments after anti-VEGF therapy for agerelated macular degeneration[J]. Graefe's Arch Clin Exp Ophthalmol,2013,251(2):435-440.DOI:10.1007/s00417-012-2034-4.
20. Shin HJ,Chung H,Kim HC.Association between foveal microstructure and visual outcome in age-related macular degeneration[J].Retina,2011,31(8):1627-1636.DOI:10.1097/IAE.0b013e31820d3d01.

Chinese Journal of Ocular Fundus Diseases

Short-tern efficacy of conbercept versus ranibizumab for macular edema in central retinal vein occlusion

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