Abstract
Purpose :
Determine the half-life of Aflibercept in patients with diabetes mellitus that are vitrectomized on days 1, 3, 7, 14 or 30 days after intravitreal injection, as well as its relationship with Vascular Endothelial Growth Factor intravitreal concentration.
Methods :
Pilot, cross-sectional and interventional study that included patients between 18 and 80 years old with proliferative diabetic retinopathy and vitreous hemorrhage or small fibrovascular proliferations without traction in the period from May 1, 2021 to December 31, 2022. Selected patients required pars plana vitrectomy surgery with or without combined phacoemulsification. Patients were randomized into five groups depending on the time of intravitreal aflibercept application prior to their surgery (1, 3, 7, 14 or 30 days). For sample collection, 0.2 cc of aqueous and vitreous humor were taken in a controlled manner through trans-surgical paracentesis and vitrectomy port. The amount of aflibercept and VEGF were analyzed by ELISA.
Results :
A total of 24 eyes were included, with a mean age of 63 years. The concentration of aflibercept in aqueous humor remained high during the first 3 days, decreasing progressively from de first week until it was undetectable by day 30. In vitreous, the concentration of aflibercept remained at constant and detectable levels until day 30. VEGF analysis is still pending and will be carried out during January 2023.
Conclusions :
Our study indicates that the concentration of aflibercept in vitreous and in aqueous humor does not behave similarly, since the concentration in vitreous remains stable even for 30 days. Therefore, it is calculated that the half-life is longer than that described in animal trials. Knowing the behavior of VEGF, it will be possible to determine the time in which the antiangiogenic concentration continues to be effective for angiogenic inhibition.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.