June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Foveal capillary perfusion density decreases in diabetics with DME treated on a fixed regimen of intravitreal aflibercept injections over 24 months
Author Affiliations & Notes
  • Brittney Statler
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Thais Conti
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Felipe Ferreira Conti
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Fabiana Q Silva
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Aleksandra Rachitskaya
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Alex Yuan
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Andrew Schachat
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Justis P Ehlers
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Jonathan E Sears
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Rishi P Singh
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Amy Babiuch
    Ophthalmology, Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Brittney Statler, None; Thais Conti, None; Felipe Ferreira Conti, None; Fabiana Q Silva, Ocular Therapeutix (E); Aleksandra Rachitskaya, Alcon (C), Allergan (C), Novartis (S), Zeiss (C); Alex Yuan, None; Andrew Schachat, None; Justis Ehlers, Aerpio (F), Aerpio (C), Alcon (F), Alcon (C), Allegro (C), Allergan (F), Allergan (C), Genentech (F), Genentech/Roche (C), Leica (C), Leica (P), Novartis (F), Novartis (C), Regeneron (F), Regeneron (C), Santen (C), Thrombogenics/Oxurion (F), Thrombogenics/Oxurion (C), Zeiss (C); Jonathan Sears, None; Sunil Srivastava, Bauch and Lomb (C), Clearside (C), Eyepoint (C), Gilead (C), Novartis (C), Regeneron (C), RegenerxBio (C), Zeiss (C); Rishi Singh, Alcon/Novartis (C), Apellis (F), Bausch + Lomb (I), Genentech/Roche (C), Graybug (F), Regeneron Pharmaceuticals (C), Zeiss (I); Amy Babiuch, Genentech (C), Regeneron (F)
  • Footnotes
    Support  Regeneron Pharmaceuticals
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4360. doi:
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      Brittney Statler, Thais Conti, Felipe Ferreira Conti, Fabiana Q Silva, Aleksandra Rachitskaya, Alex Yuan, Andrew Schachat, Justis P Ehlers, Jonathan E Sears, Sunil K Srivastava, Rishi P Singh, Amy Babiuch; Foveal capillary perfusion density decreases in diabetics with DME treated on a fixed regimen of intravitreal aflibercept injections over 24 months. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4360.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate changes in capillary perfusion density (CPD) in patients with diabetic macular edema (DME) undergoing fixed intravitreal aflibercept injections (IAI) through 24 months in the SWAPTWO study

Methods : SWAPTWO is a prospective, interventional, single arm study enrolling 20 patients with persistent DME despite prior treatment with bevacizumab or ranibizumab. All patients received IAI every 4 weeks until DME resolution and were then extended to fixed q8week dosing for the duration of the study. OCTA (Optovue Inc, California, USA) was obtained at baseline, 6-months, 12-months, and 24-months. Superficial and deep CPD changes from baseline were measured, and correlations between final visual acuity (VA) and fovea-only, parafoveal and foveal+parafoveal (“whole”) CPD were analyzed at 24 months

Results : Sixteen of the 20 eyes completed the study through 24 months. The mean number of IAI received per eye during study duration was 15.2. The average CST at baseline was 420 ± 34 and improved to 251 ± 38 (p<0.001) at 24 months. VA improved from baseline at both 12- and 24-months but was only statistically significant at 24-months (+5.5 letters; p=0.042). At 24-months, whole superficial CPD decreased by 5.3% ± 3.1 from baseline (p=0.001); deep CPD decreased by 4.4% ± 3.3 (p=0.009). Better final VA was positively correlated with less CPD loss within the superficial parafovea [r= +0.66 (0.23,0.88); p=0.006) and whole [r= +0.60 (0.12, 0.85); p=0.017] areas. There was no statistical significance correlation between final VA and the following: mean superficial fovea-only CPD values and deep foveal, parafoveal and whole CPD values

Conclusions : Despite fixed q8week dosing with IAI after DME resolution through 24 months, both superficial and deep CPD measurements decreased, suggesting that perfusion continues to be affected despite fixed anti-VEGF dosing. Better final VA was correlated with less CPD loss within the superficial parafovea and “whole” (fovea+parafovea) areas

This is a 2020 ARVO Annual Meeting abstract.

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