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Hamzah Khalaf, Mahdi Rostamizadeh, Victor H Gonzalez; Foveal Avascular Zone in high risk proliferative diabetic retinopathy treated with intravitreal aflibercept injection (ELYSIAN). Invest. Ophthalmol. Vis. Sci. 2018;59(9):2789.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the size of the inner retinal foveal avascular zone in proliferative diabetic retinopathy without diabetic macular edema treated with intravitreal aflibercept.In this study, we compare monthly aflibercept and as needed aflibercept after 4 monthly injections in the treatment of high risk proliferative diabetic retinopathy.
This is part of a randomized single-masked clinical trial comparing monthly aflibercept and as needed aflibercept after 4 monthly injections. OCT angiography was done on patients using DRI OCT Triton, Swept Source OCT angiography by Topcpon. OCT-A was done every month throughout the duration of the study (12 months). Scans were reviewed to identify subjects with scans having sufficient clarity for FAZ measurement. The area of FAZ was measured using the ImageNet software. 2 experienced observers measured FAZ area independently and the results were averaged.
After reviewing the OCT-A studies, 14 subjects had appropriate scans for FAZ measurements. 9 subjects received PRN aflibercept while 5 subjects received monthly aflibercept. The mean number of injections was 10.2 in monthly aflibercept and 4.8 in PRN aflibercept. The spearman test showed strong positive interobserver correlation (R=0.95).The overall average initial FAZ was 0.438mm2 and final FAZ was 0.566mm2 (p=0.258). The mean FAZ area in monthly aflibercept was 0.400mm2 at initial scan and 0.512mm2 at final scan (p=0.298). The mean FAZ area in PRN aflibercept was 0.460mm2 at initial scan and 0.596mm2 at final scan (p=0.596). The average change in FAZ area was 0.222mm2 overall, 0.113mm2 in monthly aflibercept group, and 0.283mm2 in PRN aflibercept group (p=0.352). A larger portion of subjects had enlargement of FAZ by 0.100mm2 or more in PRN aflibercept (67%) than in monthly aflibercept (20%).
When analyzing the area of FAZ in PDR during aflibercept treatments, there is no significant difference between initial and final measurements nor between different treatment regimens. There was a trend towards more FAZ enlargement in PRN aflibercept when compared to monthly aflibercept.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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