RETINAL LEAKAGE INDEX DYNAMICS ON ULTRA-WIDEFIELD FLUORESCEIN ANGIOGRAPHY IN EYES TREATED WITH INTRAVITREAL AFLIBERCEPT FOR PROLIFERATIVE DIABETIC RETINOPATHY IN THE RECOVERY STUDY

• Published in: Retina (Philadelphia, Pa.) Vol. 40; no. 11; p. 2175
• Main Authors: Babiuch, Amy S, Wykoff, Charles C, Srivastava, Sunil K, Talcott, Katherine, Zhou, Brenda, Hach, Jenna, Hu, Ming, Reese, Jamie L, Ehlers, Justis P
• Format: Journal Article
• Language: English
• Published: United States 01.11.2020
• Subjects: Adult; Aged; Angiogenesis Inhibitors - therapeutic use; Blood-Retinal Barrier - physiology; Capillary Permeability - physiology; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - drug therapy; Diabetic Retinopathy - physiopathology; Female; Fluorescein Angiography; Humans; Intravitreal Injections; Male; Middle Aged; Prospective Studies; Receptors, Vascular Endothelial Growth Factor - therapeutic use; Recombinant Fusion Proteins - therapeutic use; Retinal Vessels - physiopathology; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity
• ISSN: 1539-2864
• DOI: 10.1097/IAE.0000000000002727

Characterization of leakage indices on ultra-widefield fluorescein angiography in proliferative diabetic retinopathy treated with intravitreal aflibercept. Prospective study enrolling subjects for treatment of proliferative diabetic retinopathy randomized 1:1 to receive 2-mg intravitreal aflibercept every 4 weeks (2q4) or every 12 weeks (2q12). Ultra-widefield fluorescein angiography images obtained at baseline, 24, and 48 weeks were analyzed using a semiautomated leakage segmentation platform. Panretinal and zonal leakage indices were calculated. Forty eyes of 40 subjects were included, and mean age was 48 ± 12.1 years. Mean number of injections was 11 ± 1.7 in the 2q4 arm and 4 ± 0.4 in the 2q12 arm. Median baseline leakage index in the 2q4 and 2q12 groups was 5.1% and 4.3%, respectively (P = 0.28). At 24 and 48 weeks, the 2q4 group significantly improved to 1.1% (-79%, P < 0.0001). At Week 24, the 2q12 group demonstrated nonsignificant improvement (3.4%; -21%, P = 0.47); by Week 48, improvement was significant (1.4%; -68%, P = 0.02). The 2q4 group resulted in lower leakage index compared with the 2q12 group at 24 weeks (1.1% vs. 3.4%, respectively; P = 0.008), but by 48 weeks, leakage index was similar between both groups (1.1% vs. 1.4%, respectively; P = 0.34). Proliferative diabetic retinopathy treated with intravitreal aflibercept demonstrated significant leakage index reductions at 1 year. Monthly dosing provided more rapid reduction in leakage index compared with quarterly dosing. RECOVERY study (NCT02863354); https://clinicaltrials.gov/ct2/show/NCT02863354.