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. 2021 May 11:15:1971-1978.
doi: 10.2147/OPTH.S304030. eCollection 2021.

One-Year Outcome of Aflibercept Intravitreal Injection in Vitrectomized Eyes with Diabetic Macular Edema

Thi Ha Chau Tran  1 , Ali Erginay  2 , Stephane Verdun  3 , Eric Fourmaux  4 , Jean-François Le Rouic  5 , Joel Uzzan  6 , Solange Milazzo  7 , Stephanie Baillif  8 , Laurent Kodjikian  9
Affiliations

One-Year Outcome of Aflibercept Intravitreal Injection in Vitrectomized Eyes with Diabetic Macular Edema

Thi Ha Chau Tran et al. Clin Ophthalmol. .

Abstract

Aim: To evaluate the efficacy of intravitreal Aflibercept injection (IAI) for vitrectomized eyes with diabetic macular edema (DME) at one year.

Methods: This is a prospective, non-comparative, multicenter observational study including diabetic patients whose HbA1c is < 9%, with visual acuity between 20/400 to 20/40 due to DME, who have undergone vitrectomy since at least 3 months before the first aflibercept injection. Treatment protocol included 5 monthly aflibercept injection followed by a ProReNata regimen during the first year. Visual acuity, OCT findings and number of IAI were assessed at 6 months and one year.

Results: Forty-six eyes were included. Indications for vitrectomy were epiretinal membrane (58.7%), intravitreal hemorrhage (26.1%), and vitreomacular traction (8.7%), retinal detachment (4.3%), and other cause (4.3%). Median duration of macular edema was 3 years. Median interval between vitrectomy and first visit was 9 months. Thirty eyes were non-naïve and received previously thermal laser (44.3%), intravitreal injection of triamcinolone (26.7%), of ranibizumab (70%), of dexamethasone implant (36.7%), or bevacizumab (6.7%). Data was available for 35 eyes at 1 year. Visual gain was significant, +6 letters (p <0.001) and central subfield thickness (CST) decreased significantly (-108μm, p < 0.001) at 1 year. Mean number of injections was 9.3 and mean interval injection was 5.8 weeks.

Conclusion: These results suggest that IAI may be beneficial in vitrectomized eyes with refractory DME which require frequent injections to obtain visual and anatomical improvement.

Clinical trial registration: http://www.clinicaltrials.gov, registration Number NCT02874859.

Keywords: DME; aflibercept; anti-VEGF; diabetic macular edema; vitrectomy.

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Conflict of interest statement

Prof. Dr. Thi Ha Chau Tran reports consultancy for Bayer Healthcare, and personal fees from Novartis, Allergan during the conduct of the study. Dr Ali Erginay reports non-financial support from Bayer, Novartis, outside the submitted work. Dr Joel Uzzan reports personal fees from Allergan and being a consultant and investigator for Bayer and Novartis, outside the submitted work. Prof. Stephanie Baillif reports consultancy for Bayer, Novartis, Allergan, and Horus Pharma, during the conduct of the study. Prof. Dr. Laurent Kodjikian reports personal fees from Bayer, Allergan, Novartis, and Roche, during the conduct of the study. The authors report no other potential conflicts of interest for this work and report no proprietary or commercial interest in any materials discussed in this article.

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