Aflibercept combined with focal/grid photocoagulation improves outcomes in DME
Patients with diabetic macular edema (DME) treatment with a combination of intravitreal aflibercept and post-loading focal/grid photocoagulation achieved better functional outcomes despite fewer injections, according to a study.
In this exploratory study, 43 eyes from 32 patients from a previously published study receiving combined intravitreal aflibercept and focal/grid photocoagulation and 46 eyes from 38 receiving standard-of-care were included. Patients in the study population received a loading dose of 3 monthly aflibercept injections followed by focal/grid photocoagulation and additional aflibercept as needed.
There were no differences regarding age, sex, body mass index, hemoglobin A1 C, systolic pressure, or type of diabetes between the real-world population receiving standard of care treatment and the study population at baseline. The study population had a higher diastolic pressure (81.6 vs 72.1 mmHg) and lower duration of diabetes (12.3 vs 23.2 years) compared to the group receiving standard of care.
At month 12, patients in the study group had a higher visual acuity with 79.6 ETDRS letters and had received 4.4 injections compared with 74.3 ETDRS letters and 5.9 injections in the standard of care group. The study group was also more likely to have only received the 3 loading dose injections (39.5% vs 13%).
Additional studies are needed to evaluate the long-term efficacy of the combined treatment.
Jørgensen MM, Vestergaard AH, Blindbaek SL et al. Functional and structural efficacy of a novel combinational therapy of aflibercept and timely focal/grid photocoagulation in diabetic macular oedema: do clinical study results compare favourably with a standard-of-care treated real-world population? Acta Ophthalmol. 2022;doi: 10.1111/aos.15196. Epub ahead of print. PMID: 35673897.