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

Thi Ha Chau Tran; Ali Erginay; Stephane Verdun; Eric Fourmaux; Jean-François Le Rouic; Joel Uzzan; Solange Milazzo; Stephanie Baillif; Laurent Kodjikian

doi:10.2147/OPTH.S304030

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

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

Authors

Thi Ha Chau Tran¹, Ali Erginay², Stephane Verdun³, Eric Fourmaux⁴, Jean-François Le Rouic⁵, Joel Uzzan⁶, Solange Milazzo⁷, Stephanie Baillif⁸, Laurent Kodjikian⁹

Affiliations

¹ Service d'Ophtalmologie, Université Catholique de Lille, Faculté de Médecine et Maieutique, INSERM U1171, Lille, France.
² Service d'Ophtalmologie, Hôpital Lariboisière APHP, Universite de Paris, Paris, France.
³ Département de Recherche Médicale, Groupement des Hôpitaux Catholiques de Lille, Lille, France.
⁴ Centre Rétine Gallien, Bordeaux, France.
⁵ Institut Ophtalmologique de l'Ouest Jules Verne, Ophtalliance, Nantes, France.
⁶ Clinique Mathilde, Rouen, France.
⁷ Service d'Ophtalmologie, Centre Hospitalier Universitaire d'Amiens Picardie, Université de Picardie Jules Verne, Amiens, France.
⁸ Service d'Ophtalmologie, Centre Hospitalier Université Côte d'Azur, Université Côte d'Azur, Nice, France.
⁹ Service d'Ophtalmologie, Croix Rousse Hospital, Hospice Cilvils de Lyon 1, Université de Lyon 1, Lyon, France.

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.

Associated data

ClinicalTrials.gov/NCT02874859

Grants and funding

The first author got the funding from Eurasante call for projects of the North of France Region. The Medical Research Department of Lille Catholic Hospitals received funding from Bayer Healthcare SAS to run the study. The sponsor had no role in the design or conduct of this research.