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Andrea Consigli, Athanasios Papanastasiou, Sayon Roy, Gabriele Thumann, Argyrios Chronopoulos; Intravitreal Aflibercept reduces the retinal vessel diameter in patients with diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2118.
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© 2017 Association for Research in Vision and Ophthalmology.
In the course of diabetic retinopathy (DR) initial retinal vessels dilation, a biomarker for DR progression, shifts to constriction, which signifies potential proliferative state. The aim of this study was to assess retinal vessel diameter changes in relation to macular edema formation following intravitreal treatment with aflibercept in patients with diabetic macular edema (DME)
Seven treatment naive patients (9 eyes) aged 60 ± 11 years with DME were followed one week before and after during the loading phase of intravitreal treatment with Aflibercept. Static retinal vessel analysis as well as optical coherence tomography (OCT) scans were performed at every examination. Further analysis included systemic blood pressure before each measurement as well as HbA1c values throughout the time course of the study.
Static retinal vessel analysis demonstrated a reduction in retinal artery diameter from 95.59±10.68 μm to 93.63±11.77 μm at end of first month, to 87.6±5 μm at end of third month after initiation of Aflibercept treatment. The reduction in retinal artery diameter one week after the the third injection was statistically significant (p < 0.05). Similarly, retinal vein diameter was reduced from 117.14±10.4 μm to 110.2±7 μm at end of first month to 109±7 μm at end of third month. The reduction in retinal vein diameter one week after the third injection was statistically significant (p < 0.05). DME, as assessed by OCT, decreased significantly from 467±96.5 μm (baseline) to 344±97.3 μm (month 3) (p = 0.0434). Regression analysis demonstrated a significant correlation between decreased retinal artery diameter and macular edema reduction (p < 0.001 and p > 0.05 for retinal arteries and veins respectively).
Intravitreal Aflibercept injection in eyes with DME resulted in significant reduction in the diameter of both retinal arteries and veins by 3 months. Furthermore the reduction in DME was significantly correlated with the arterial diameter reduction. These data seem to indicate a restoration of the normal vessel caliber under Aflibercept treatment with potential implications in the pathogenesis and treatment of DME.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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