Morphological and functional changes in the macular area in diabetic macular edema after a single intravitreal injection of aflibercept

Abstract

AIM: To evaluate the changes in macular morphology and function after a single intravitreal injection of aflibercept in diabetic macular edema (DME) using optical coherence tomography angiography (OCTA) and MP-3 microperimetry. METHODS: Twenty-eight patients (42 eyes) diagnosed with DME were treated with intravitreal injection of aflibercept. The changes in best corrected visual acuity (BCVA), central retinal thickness (CRT), foveal avascular zone (FAZ) area, vessel density of superficial retinal capillary plexus (SVD), vessel density of deep retinal capillary plexus (DVD), mean light sensitivity (MLS), 2° fixation rate (P1), 4° fixation rate (P2), and other indicators 1mo after treatment were compared; of these, BCVA was converted into logarithm of the minimum angle of resolution (logMAR), and the correlation among the factors was analyzed. RESULTS: After treatment, logMAR BCVA was 0.47±0.24, which was significantly better than that before treatment (0.63±0.28, P<0.001). The CRT was 359.21±107.87 μm after treatment, which was significantly lower than before treatment (474.10±138.20 μm, P<0.001). The FAZ area, SVD, and DVD were not significantly changed after treatment compared with the baseline. MLS was 22.16±4.20 dB after treatment, which was significantly higher than before treatment (19.63±4.23 dB, P<0.001). P2 significantly increased after treatment than before treatment (P=0.007). P1 had no significant change after treatment than before treatment (P=0.086). CONCLUSION: A single intravitreal injection of aflibercept effectively reduces macular edema and improves retinal sensitivity, fixation stability, and visual acuity, possibly without causing significant changes in the retinal vascular condition in a short time.

Aflibercept combined with triamcinolone acetonide in the treatment of diabetic macular edema: optical coherence tomography and optical coherence tomography angiography

“…Malagola et al [29] reported that after intravitreal injection of aflibercept to treat DME (observation time points were 3-25mo), there was no significant change in retinal microvascular density. The results of Zhang et al [30] showed that the FAZ area and retinal capillary density may not change significantly in the short term after receiving anti-VEGF therapy. In our study, there was no significant change in FAZ area in either the combination therapy group or the aflibercept group, which is consistent with the results of the above studies.…”

Treatment of diabetic macular edema: Bibliometric analysis

“…In addition, the growing number of annual citations also re ects the growing in uence of related publications. On the one hand, this growth trend is due to the endless stream of DME treatment methods: including ranibizumab, bevacizumab, a ibercept, dexamethasone and other medicine [34][35][36] ; on the other hand, it is due to the gradual increase in the evaluation methods of the therapeutic effect of diabetic macular edema, such as optical correlation tomography angiography [37,38] . The year 2020 witnessed the largest published number on the treatment of DME throughout the past decade, which may be related to the ranibizumab's patent expired in the United States.…”

Time in range as a useful marker for evaluating retinal functional changes in diabetic retinopathy patients

“…Furthermore, DR-associated retinal neurodegeneration might occur before any detectable microcirculatory abnormalities in ophthalmic examinations [9] . Microperimetry offers a possibility to record assessment of retinal sensitivity and the location and stability of fixation [10][11] . It has been reported that retinal sensitivities are decreased compared to control subjects in type 2 diabetes patients without DME [12] .…”