Targeted retinal laser photocoagulation doesn’t reduce burden of aflibercept injections for DMO

Targeted retinal laser photocoagulation (TPRP) to peripheral retinal ischaemia retina does not reduce the burden of intravitreal aflibercept injections when treating diabetic macular oedema (DMO), according to a study.

In this study prospective, double-masked, multicenter, randomized controlled trial that compared aflibercept monotherapy with combination therapy of aflibercept and TPRP for DMO, 48 eyes of 47 patients were included, with 27 eyes randomized to combination therapy (aflibercept and TPRP) and 21 to aflibercept monotherapy.

The primary outcome measure was the mean number of intravitreal aflibercept injections for each group at 24 months, while secondary outcomes included mean change in central macular thickness (CMT) and vision at trial completion, the proportion of eyes whose DMO resolved and the mean injection treatment interval. Ocular and systemic adverse events were also recorded.

The number of intravitreal treatments given were similar for combination therapy and monotherapy. The mean visual improvement, mean decrease in CMT, proportion of eyes with CMT <300 µm, and safety outcomes were similar in both the combination and monotherapy treatment groups.

Reference
Cornish EE, Wickremasinghe S, Mehta H, et al. Aflibercept monotherapy versus aflibercept with targeted retinal laser to peripheral retinal ischemia for diabetic macular oedema (LADAMO). Eye (Lond). 2023;doi: 10.1038/s41433-023-02525-9. Epub ahead of print. PMID: 37069239.