PURPOSE: Incidence of diabetes mellitus (DM) increases rapidly in our country as well as around the world, posing a serious threat to public health. Diabetic retinopathy (DR) is the most common microvascular complication in patients with DM since microvascular damage secondary to chronic hyperglycemia starts affecting retina in the early stages of the disease. Our aim is to evaluate the real-life outcomes of intravitreal aflibercept monotherapy in treatment naïve cases with diabetic macular edema (DME).
METHODS: Retrospective case control study. Medical charts of 75 treatment naïve cases with DME were reviewed retrospectively. A total of 127 eyes that received intravitreal aflibercept monotherapy between January 2017 and December 2018 in our Retina Unit were enrolled. Demographics and the results of their initial and all follow-up ophthalmologic examinations as well as the number and frequency of intravitreal shots were noted for each participant. Chi-square, Mann Whitney U and Wilcoxon signed rank tests were used for statistical analysis.
RESULTS: Of the total 75 patients with a mean age of 61.2±10.4 years, 38 (50.7%) were male. Mean follow-up period was 10.2±6.3 months. Mean baseline best-corrected visual acuity and central macular thickness scores were 56.8±19.9 ETDRS letters and 397.8±162.4 μm; whereas they were found as 67.9±16.9 ETDRS letters and 311.0±116.8 μm at the last visit (p<0.001 and p<0.001, respectively). Aflibercept monotherapy was found to provide better anatomic prognosis in eyes with serous macular detachment (p<0.001), and better anatomic as well as functional prognosis in eyes without any concomitant vitreomacular interface disorders (p=0.037 and p=0.042, respectively).
CONCLUSION: Intravitreal aflibercept monotherapy proves to be an effective and reliable treatment option in treatment-naïve DME cases, even in those with marked OCT biomarkers indicating poor outcomes.