Evidence map›Paper›PMID 38971923›Full record

ArticleEye (London, England)2024

The effect of four loading intravitreal aflibercept injections on macular fluid in treatment-naïve neovascular age-related macular degeneration.

Shruti Chandra, Raffaele Raimondi, Alicia Lim, Amy Mohan, Sneha Melmane, Geeta Menon, Manju Chandran, Sobha Sivaprasad, Benjamin J L Burton, Ajay Kotagiri

Abstract readMulticenter Study
In one paragraph

Article in Eye (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Shruti ChandraNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, EC1V 2PD, UK. shruti.chandra@nhs.net.ORCID http://orcid.org/0000-0002-2634-9775
Raffaele RaimondiSouth Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.
Alicia LimNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, EC1V 2PD, UK.
Amy MohanFrimley Health NHS Foundation Trust, Surrey, UK.
Sneha MelmaneFrimley Health NHS Foundation Trust, Surrey, UK.
Geeta MenonFrimley Health NHS Foundation Trust, Surrey, UK.
Manju ChandranFrimley Health NHS Foundation Trust, Surrey, UK.
Sobha SivaprasadNational Institute of Health Research Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, EC1V 2PD, UK.
Benjamin J L BurtonJames Paget University Hospitals NHS Foundation Trust, Norfolk, UK.ORCID http://orcid.org/0000-0001-9579-9078
Ajay KotagiriSouth Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the effect of four versus three loading aflibercept injections on macular fluid resolution and visual acuity (VA) in exudative neovascular AMD (nAMD).

methodsMulticentre, retrospective cohort study of treatment naïve nAMD eyes undergoing 3 versus 4 loading doses of aflibercept. Change in VA and fluid resolution on optical coherence tomography (OCT), were evaluated at 8 weeks post loading. The primary outcome was proportion of patients with no intraretinal (IRF) and/or subretinal (SRF) fluid at central 1 mm and whole macula at 8 weeks after loading. Data were summarised with mean ± SD for continuous variables, and n (%) for categorical variables.

resultsData from 995 patients was analysed (355 patients - 4 loading doses and 640-3 loading doses). At 8 weeks post 4 loading doses proportion of eyes with neither IRF nor SRF, no IRF and no SRF were 62.8%, 88.7% and 79.2% at fovea versus 56.1%, 87.9% and 69.9% in the whole macula, respectively. Fluid resolution at both fovea and macula were significantly higher in eyes with 4 loading injections versus 3 (p = 0.0001). The mean VA change was +4.0 (±11.3) and +5.4(±13.3) letters for 3 and 4 loading doses groups (p = 0.09).

conclusionFour loading dose injections of aflibercept results in higher proportion of eyes with total fluid resolution in the central subfield and total macular scan when compared to those receiving 3 loading dose injections at 8 weeks post loading phase. However, the better drying effect of 4th loading dose does not translate into better short-term VA outcomes.

Indexed as

Angiogenesis InhibitorsIntravitreal InjectionsReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsSubretinal FluidTomography, Optical CoherenceVisual AcuityWet Macular DegenerationAgedAged, 80 and overFemaleFluorescein AngiographyHumansMacula LuteaMaleMiddle AgedafliberceptAngiogenesis InhibitorsReceptors, Vascular Endothelial Growth FactorRecombinant Fusion ProteinsVascular Endothelial Growth Factor AVEGFA protein, human

Identifiers

PMID38971923
PMCPMC11461640

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.