Department of Ophthalmology, Mie University Graduate School of Medicine, Mie, Japan.
Mie University Graduate School of Medicine, Faculty of Medicine, Mie, Japan.
Transl Vis Sci Technol. 2020 Oct 6;9(11):2. doi: 10.1167/tvst.9.11.2. eCollection 2020 Oct.
To determine the effectiveness of intravitreal aflibercept (IVA) on the retinal function in eyes with diabetic macular edema (DME).
Twenty-five eyes of 25 patients with DME were treated with three consecutive monthly IVA injections. The retinal sensitivities (RS) within the central 10° were determined by microperimetry (MP). The central subfield macular thickness (CMT) was determined by optical coherence tomography, and the implicit times (IT) and amplitudes (Amp) of the flicker electroretinograms (ERGs) were determined from the ERGs elicited and recorded by the RETeval. The number of microaneurysms (MAs) was counted in the fundus photographs. The assessments were made before the IVA injections (pre-IVA) and one week after the IVA injections (post-IVA). The correlations between the reduction ratio of the MA numbers/CMT and RS/IT/Amp were evaluated.
The mean RS improved from 19.9 ± 5.9 dB to 22.0 ± 5.8dB, the CMT decreased from 485.7 ± 90.6 µm to 376.9 ± 81.6 µm, and the number of MAs decreased from 49.6 ± 33.2 to 24.8 ± 18.1 after the IVA injection (all < 0.01). The changes in the IT from 31.3 ± 3.3 ms to 31.5 ± 3.1 ms and the Amp from 12.2 ± 5.5 µV to 11.3 ± 6.1µV post-IVA were not significant. A significant correlation was found between the relative changes in the CMT and RS ( = -0.43; = 0.02), the MAs and RS ( = -0.38; = 0.03). No significant correlation was observed between the relative changes of the number of MAs/CMT and IT/Amp.
IVA can improve both central retinal function and anatomical conformation.
A new aspect of aflibercept will be useful for DME treatment.
评估玻璃体内注射阿柏西普（IVA）对糖尿病黄斑水肿（DME）患者视网膜功能的影响。
对 25 例（25 只眼）DME 患者行连续 3 次每月 IVA 注射治疗。微视野计（MP）检测中央 10°内视网膜敏感度（RS）。光学相干断层扫描（OCT）测量黄斑中心凹视网膜厚度（CMT），视网膜电图仪（RETeval）记录和引出闪烁视网膜电图（ERG），计算闪光 ERG 的隐时（IT）和振幅（Amp）。眼底照相计数微动脉瘤（MA）数量。IVA 注射前（IVA 前）和注射后 1 周（IVA 后）进行各项评估。评估 MA 数量/CMT 减少率与 RS/IT/Amp 减少率之间的相关性。
治疗后平均 RS 从 19.9 ± 5.9dB 提高到 22.0 ± 5.8dB，CMT 从 485.7 ± 90.6µm 降低至 376.9 ± 81.6µm，MA 数量从 49.6 ± 33.2 个减少至 24.8 ± 18.1 个（均<0.01）。注射后 IT 从 31.3 ± 3.3ms 变为 31.5 ± 3.1ms，Amp 从 12.2 ± 5.5µV 变为 11.3 ± 6.1µV，但差异均无统计学意义。CMT 与 RS 的相对变化呈显著负相关（ = -0.43； = 0.02），MA 与 RS 的相对变化呈显著负相关（ = -0.38； = 0.03）。MA 数量/CMT 的相对变化与 IT/Amp 无显著相关性。
IVA 不仅能改善视网膜解剖结构，还能提高中心视网膜功能。
阿柏西普在 DME 治疗方面可能具有新的应用价值。
