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Muneeswar Gupta Nittala, wenying fan, Swetha Bindu Velaga, Shaun Lampen, Michael S Ip, Charles Clifton Wykoff, Srinivas R. Sadda; Effect of Intravitreal Aflibercept on Optical Coherence Tomography Angiography Vessel Density in Subjects with Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1914. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of intravitreal aflibercept on vessel density and flow index using optical coherence tomography angiography (OCTA) in subjects with proliferative diabetic retinopathy (PDR) without diabetic macular edema (DME).
A total of 30 eyes of 30 subjects were enrolled in this phase 2, IRB approved, prospective, multi-center clinical trial (NCT02863354). Study subjects were randomized into monthly and quarterly injection cohorts and treated for 6 months. All subjects underwent diagnostic testing with ultrawide field fundus images (pseudocolor and fluorescein angiography) using an Optos 200Tx (Optos, Dunfermline, UK) and OCTA (3X3 mm) using the RTVue-XR 100 Avanti (Optovue, Inc., Fremont, CA, USA). Capillary vessel density (superficial and deep retina, and choriocapillaris) was measured within the entire scan and in foveal and parafoveal regions, and flow index (outer retinal and choroid) was measured in the entire scan. Measurements were compared before and six months after anti-vascular endothelial growth factor (VEGF) injections using Wilcoxon Signed Ranks Test (SPSS ver. 18.0).
The mean age of study subjects was 48 ± 12 years. Total image, foveal and parafoveal vessel density in the superficial and deep retina, and choriocapillaris were not significantly different before and after intravitreal anti-VEGF injection (p > 0.05). The choroid flow index was significantly increased at month 6 (p = 0.04) (Table). There was no significant difference in vessel density and flow index parameters between monthly and quarterly injection arms (p > 0.05), but the study may have been underpowered for this assessment.
In this study of eyes with PDR without DME, macular capillary density did not show a significant change at 6 months following anti-VEGF therapy.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Table: Difference in OCTA Vessel density and Flow between baseline and month 6 visits
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