Abstrato

Ultra wide-field fluorescein angiographic-guided aflibercept (WFFAGA) monotherapy for proliferative diabetic retinopathy (PDR).

Dennis M Marcus, Caitlen Taylor, Davis Starnes, Evin M Samy, Venkatkrish M Kasetty, Rachel Levy, Lindsay Williamson, Priscila Rex, Harinderjit Singh, Robert A Lalane

Background/objectives: To assess injection burden, visual, anatomic and safety outcomes in proliferative diabetic retinopathy (PDR) eyes after aflibercept monotherapy using wide-field fluorescein angiographic (WFFA) guided therapy.

Subjects/methods: We retrospectively evaluated 17 non-study fellow LASERLESS trial PDR eyes that received WFFA guided aflibercept. Fellow eyes prospectively underwent best-corrected visual acuity (BCVA), optical coherence tomography (OCT) and ocular examinations with quarterly WFFA. After baseline aflibercept, aflibercept was administered for PDR progression based on clinical examination and WFFA evaluation.

Results: Through 52 weeks 17 PDR eyes with no previous pan-retinal photocoagulation (PRP) received an average 5.7 injections. Average BCVA at baseline and 52 weeks were 76 letters (20/32) and 80 letters (20/25) respectively. Average OCT thickness at baseline and 52 weeks were 279 um and 261 um respectively. Ocular adverse events included progression or new vitreous hemorrhage, any PDR progression and new diabetic macular edema (DME).

Conclusion: WFFA monitoring of neovascularization helps guide clinicians to assess PDR status and may lead to optimal aflibercept monotherapy dosing with excellent outcomes for PDR eyes.