PU Conference Series: Euretina 2018

" While intravitreal aflibercept within 1 week of panretinal photocoagulation may work, many recommend initial intravitreal therapy with IOP-lowering drops followed by panretinal photocoagulation within 1 week instead. The initial intravitreal therapy rapidly lowers IOP, stabilizes disease, and may allow for better visualization for panretinal photocoagulation to be performed. "

randomized to aflibercept at baseline could receive sham injection at week 1 and aflibercept injections at weeks 5 and 9, whereas patients randomized to sham injection at baseline could receive aflibercept injections at each subse- quent timepoint. The majority of patients received only 1 aflibercept injection (aflibercept arm: 77.8% vs sham arm: 74.1%). A limitation of the study was that, while baseline demographics were balanced between study arms, there was an imbal- ance in disease characteristics between the aflibercept and sham groups, includ- ing an imbalance in disease duration, IOP, and iris neovascularization grade. In a comment on the study to Elsevier's PracticeUpdate , Raza Shah, MD, of Mid Atlantic Retina Specialists in Hagerstown (who was not involved in the study), noted that, "While intravitreal aflibercept within 1 week of panretinal photocoagulation may work, many recommend initial intravitreal therapy with IOP-lowering drops followed

by panretinal photocoagulation within 1 week instead. The initial intravitreal ther- apy rapidly lowers IOP, stabilizes disease, and may allow for better visualization for panretinal photocoagulation to be per- formed. In practice, it’s not uncommon for neovascularization of iris and neovascular glaucoma to be completely resolved follow- ing 1 intravitreal injection. This allows time for staged panretinal photocoagulation

and even anterior segment micropulse laser or stent to be performed for concur- rent/future IOP control."

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EURETINA 2018 • PRACTICEUPDATE CONFERENCE SERIES