Retrospective study of aflibercept in combination therapy for high-risk proliferative diabetic retinopathy and diabetic maculopathy

Int Ophthalmol. 2021 Jun;41(6):2157-2165. doi: 10.1007/s10792-021-01773-6. Epub 2021 Mar 27.

Abstract

Purpose: To evaluate whether anti-vascular endothelial growth factor (VEGF) therapy combined with panretinal photocoagulation could reverse diabetic retinopathy (DR).

Method: Fifty-two patients (72 eyes) with high-risk proliferative DR who were diagnosed and treated from June 2018 to May 2019 were divided into the laser group (16 cases, 32 eyes) and combination group (36 cases, 40 eyes) according to a review of the medical records.

Results: Within-group comparison: There were no significant differences in best-corrected visual acuity (BCVA), central foveal thickness (CFT), and microaneurysms in the laser group before and after treatment, but there were statistically significant improvements in the combination group. After the treatment, the BCVA of the patients in the combination group was 0.44 ± 0.17, which was significantly better than 0.70 ± 0.18 before treatment; the CFT after treatment was 266.51 ± 33.28 μm, which was significantly lower than 382.37 ± 54.03 μm at baseline; the MA after treatment was 56.12 ± 23.29, which was significantly lower than 121.44 ± 40.35. There was a statistically significant decrease in hard exudates area in both two groups before and after treatment. Comparison between groups: The difference in BCVA, CFT, MA and between the two groups was statistically significant (all P < 0.05), and the area of retinal neovascularization between the two groups was no significant difference, but decreased more rapidly in the combination group than that in the laser group.

Conclusion: Using intravitreal injection of anti-VEGF drugs combined with panretinal photocoagulation to treat DR might morphologically and functionally reverse retinal changes caused by diabetes mellitus.

Keywords: Aflibercept; High-risk proliferative diabetic retinopathy; Panretinal photocoagulation; Safety; Therapeutic effect.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Diabetes Mellitus*
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / drug therapy
  • Humans
  • Intravitreal Injections
  • Laser Coagulation
  • Macular Degeneration* / drug therapy
  • Receptors, Vascular Endothelial Growth Factor
  • Recombinant Fusion Proteins
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Recombinant Fusion Proteins
  • aflibercept
  • Receptors, Vascular Endothelial Growth Factor