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Similarly, retinal thickness decreased more in the aflibercept and ranibizumab groups than in the bevacizumab group, but "the anatomical benefit translated into a visual acuity benefit only in eyes with a baseline visual acuity of 20/50 or worse." 2 Laser photocoagulation was pre- formed at least once between weeks 24 and 48 in 37% of the afliber- cept-treated eyes (n=76), 56% of the bevacizumab-treated eyes (n=115), and 46% of the ranibizumab-treated eyes (n=95). According to the study authors, "there were no significant differ- ences among the study groups in the rates of serious adverse events (P=.40), hospitalization (P=.51), death (P=.72), or major cardiovascu- lar events (P=.56)." Study implications In an accompanying editorial, D.F. Martin and M.G. Maguire noted 75% of patients with DME present with a baseline acuity of 20/40 or better. 2 This study found no signifi- cant differences among the 3 drugs when baseline vision was 20/40 or better, meaning cost is likely to be a consideration when planning first-line therapies. They suggested that based on cost and the findings of Protocol T, "bevacizumab should be considered as first-line therapy in patients with a visual acuity of 20/40 or better." 2 However, the study authors themselves are quick to note that eligibility criteria for the study "may not apply to eyes with persistent or recurrent diabetic macular edema that are already being treated with anti-VEGF agents." EW References 1. The Diabetic Retinopathy Clinical Research Network. Aflibercept, bevacizumab, or ranibi- zumab for diabetic macular edema. N Engl J Med. DOI: 10.1056/NEJMoa1414264 2. Martin DF and Maguire MG. Treatment choice for diabetic macular edema. N Engl J Med. DOI: 10.1056/NEJMe1500351 Uniform epithelium removal in only 5 - 7 seconds T. 800.461.1200 | www.innovativexcimer.com order online Corneal Xlinking, PRK Advanced Surface Ablation Improved clinical outcomes of CXL and PRK with Amoils Epithelial Scrubber www.innovativexcimer.com Minimize total procedure time Avoid alcohol damage to surrounding tissue No need for subsequent scraping In the news FDA approves Eylea for diabetic retinopathy T he Food and Drug Administration (FDA) expanded the approved use for Eylea (aflibercept, Regeneron Pharmaceuticals, Tarrytown, N.Y.) injection to include diabetic retinopathy (DR) in patients with diabetic macular edema (DME), the FDA said in a news release. "Diabetes is a serious public health crisis, affecting more patients every year," Edward Cox, MD, director of the Office of Antimicrobial Products in the FDA's Center for Drug Evaluation and Research, said in a release from the FDA. "[The] approval gives patients with diabetic retinopathy and diabetic macular edema another therapy to treat this vision-impairing complication." Eylea has been approved with a 5-month loading dose and then every 2 months, the FDA said. Additionally, the treatment has been granted "breakthrough therapy designation" for this indication. In February, the FDA approved Lucentis (ranibizumab injection, Genentech, South San Francisco) 0.3 mg to treat DR in patients with DME. EW

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