The effects of epiretinal membranes on the treatment outcomes of intravitreal aflibercept injection in diabetic macular
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ORIGINAL PAPER
The effects of epiretinal membranes on the treatment outcomes of intravitreal aflibercept injection in diabetic macular edema: a real-life study Ayse Gul Kocak Altintas . Cagri Ilhan . Mahmut Cankurtaran
Received: 14 March 2020 / Accepted: 23 May 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To evaluate the effects of epiretinal membrane (ERM) formation on the anatomic and functional results of subjects with diabetic macular edema (DME) who are receiving intravitreal aflibercept injections (IAIs). Materials and methods This retrospective comparative study includes 29 eyes with DME (Group 1) and 43 eyes with DME and ERM (Group 2). After three consecutive monthly 2.0 mg IAIs, subjects received monthly follow-ups and retreatment was performed if needed. Corrected visual acuity (CVA), central macular thickness (CMT), and central macular volume (CMV) parameters were recorded tri-monthly, and the 36-month follow-up was designated the primary endpoint of the study. Results There was no significant difference between groups when comparing the mean ages and male-tofemale ratios (p [ 0.05, for both). At the baseline, the mean CVA value was significantly worse (p = 0.002), and the mean CMT was significantly lower (p = 0.016) in Group 1, while there was no significant difference in terms of the mean CMV (p = 0.625). The A. G. Kocak Altintas M. Cankurtaran Ankara Ulucanlar Eye Education and Research Hospital, University of Health Sciences, Ankara, Turkey C. Ilhan (&) Hatay State Hospital, Ekinci Mah. Cevreyolu Cad. Royals Park 13/1 No: 23, Antakya, Hatay, Turkey e-mail: [email protected]
mean number of IAIs was similar at the first (p \ 0.102), second (p = 0.363), and third year (p = 0.850) follow-ups. The mean CVA was significantly worse, and CMT was significantly lower in Group 1 at most of the visits in the first half of the follow-up period (p \ 0.05, for all), while there was no significant difference in the second half of the follow-up period. There was no significant difference between groups in terms of CMV at any visit (p [ 0.05, for all). Conclusion Despite a similar number of IAIs needed, worse baseline clinical parameters are associated with poorer early- or mid-term outcomes. At the long-term follow-up, CVA and CMT became similar in DME independent of ERM. Keywords Aflibercept Central macular thickness Central macular volume Diabetic macular edema Epiretinal membrane
Introduction Diabetic macular edema (DME) is the most common reason for visual impairment in subjects with diabetes mellitus, and it is predicted that DME incidence in patients with diabetes mellitus will be doubled within 5–6 years of disease diagnosis [1]. Vascular endothelial growth factor (VEGF) is the most important cytokine for DME development in which endothelial
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Int Ophthalmol
tight junctions are damaged, the inner blood-retinal barrier is disrupted, and vascular permeability increases [2, 3]. External limiting membrane disruption leads to an accumulatio
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