Aqueous vascular endothelial growth factor after bimonthly intravitreal injection of ranibizumab or aflibercept in patients with diabetic macular edema

Abstract

Purpose : To evaluate the effect of bimonthly intravitreal injection of ranibizumab or aflibercept on aqueous vascular endothelial growth factor (VEGF) in patients with diabetic macular edema (DME).

Methods : Patients with DME (age ≥ 20 years, type 1 or type 2 diabetes mellitus, central retinal thickness ≥ 300 μm and best corrected visual acuity ≤ 0.6 decimal visual acuity) were treated bimonthly by intravitreal injection of 0.5 mg ranibizumab (IVR) or 2.0 mg aflibercept (IVA). Aqueous samples were collected just before each injection. Aqueous VEGF concentrations were measured using enzyme-linked immunosorbent assay (ELISA).

Results : Twelve patients received IVR. Median aqueous VEGF concentration was 141.9 pg/mL before IVR and significantly reduced to 70.0 pg/mL two months after IVR (p < 0.05). 7 patients received IVA. Median aqueous VEGF concentration was 160.1 pg/mL before IVA and aqueous VEGF decreased below the lower limit of detection in six of seven eyes and to 25.7 pg /mL in one eye two months after IVA (p < 0.05). There was no significant difference in aqueous VEGF before initial injections among the two groups (p = 0.704). Aqueous VEGF two months after IVA was significantly less compared with IVR (p < 0.05).

Conclusions : The aqueous VEGF decreased two months after intravitreal injection of ranibizumab or aflibercept in patients with DME. Intravitreal injections of aflibercept suppressed aqueous VEGF more than that of ranibizumab for two months.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.