Changes in retinal vessel diameters after intravitreal aflibercept in patients with diabetic macular edema

Abstract

PurposeTo evaluate changes in retinal vessel diameters after loading doses with intravitreal aflibercept in patients with diabetic macular edema (DME).MethodsThis was a three months prospective, interventional study. We included 17 patients with DME, central retinal thickness >300 μm and no active proliferative diabetic retinopathy. Previous treatment with any intravitreal vascular endothelial growth factor inhibitor was not allowed within 4 months prior to inclusion. All patients received 3 monthly intravitreal injections of aflibercept, and vessel diameters were evaluated at baseline and four weeks after the last injection. Retinal arterial and venous diameters were measured in 50‐degree disc‐centered images using the Oxymap model T1 (Oxymap, Reykjavik, Iceland) as the average diameter of the four major arterioles and venules from the four quadrants. Paired t‐test was used to test for differences in mean oxygen saturations from baseline to follow‐up.ResultsMedian age and duration of diabetes were 59.5 and 2.6 years at baseline. Median HbA1c and CRT were 65 mmol/mol and 336 μm, respectively, and 23.5% were women. Venous diameter decreased from baseline to follow‐up (157.9 μm vs. 153.2 μm, p = 0.03), whereas arterial diameter was unchanged (115.4 μm vs. 116.1, p = 0.70).ConclusionsRetinal venous diameter decreased after treatment with 3 monthly intravitreal injections of aflibercept in patients with DME, whereas no difference was found in the retinal arterial diameter. As previous studies have demonstrated that retinal venules dilate with increasing severity of diabetic retinopathy, our results suggest that treatment with intravitreal aflibercept causes positive changes to retinal vessel geometry.