Abstract
Purpose :
There is little information with inconsistent results in vitrectomized eyes with DME treated with anti-VEGF. The aim of the study is to evaluate the efficacy of intravitreal aflibercept injection (IAI) for vitrectomized eyes with diabetic macular edema (DME) at two years.
Methods :
This is a prospective, non-comparative, multicenter observational study including patients with diabetic macular edema, who have undergone vitrectomy since at least 3 months before the first aflibercept injection. All patients received 5 monthly aflibercept injections during the loading phase followed by a ProReNata until month 12. Participants were then managed at clinician discretion using Treat and Extend or Observe and plan regimen during the second year. Visual acuity, OCT findings and number of IAI were assessed at month 6, one year and two years. Change in visual acuity and central retinal thickness was assessed using Student paired t-test. Chi-squared test was used to compare the frequency of qualitative OCT parameters among eyes between baseline and at 2 years.
Results :
46 previously vitrectomized eyes were enrolled in this study. Median duration of macular edema was 3 years. Median interval between vitrectomy and first visit was 9 months. Data was available for 36 eyes at 6 months, for 34 eyes at 1 year and for 28 eyes at 2 years. Visual gain was significant: +4.6 letters at 6 months, +6 letters at 1 year and +5.4 letters at 2 years. Central macular thickness decreased significantly by 15% (- 65µm) at month 6, by 25% (-108µm) at 1 year, and by 14% (-62µm) at 2 years. Resolution of macular edema allowing discontinuation of aflibercept was observed in 7 eyes (15%). The frequency of eyes with intraretinal cyst decreased significantly from baseline to 2 years (from 89% to 64%, p = 0.046). Proportions of eyes with ellipsoid zone disruption, external limiting membrane disruption did not change significantly thorough the study. Mean number of injections was 9.3 ± 1.8 for the first year and 5.2 ± 3.1 for the second year. Mean interval injections was 1.6 ± 0.3 month for overall 2-year period.
Conclusions :
These results suggest that intravitreal Aflibercept Injection is beneficial in vitrectomized eyes leading to improvement of visual and anatomical outcome from baseline to 2 years.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.