Macular Ischemia Changes in Patients with Diabetic Macular Edema Treated with Aflibercept and Ranibizumab

Tau his study aims to assess changes in the fovea avascular zone (FAZ) in treatment na & iuml;ve patients receiving aflibercept or ranibizumab injections for diabetic macular edema (DME). Best corrected visual acuity (BCVA) testing, OCT, and OCT-angiography imaging were performed at baseline and 1 month after each injection. Injections of either aflibercept or ranibizumab were administered monthly for 6 consecutive months. FAZ in the superficial (SCP) and the deep capillary plexus (DCP) using OCT angiography was recorded for each visit. Fifty eyes from fifty patients with a mean age of 67.0 +/- 10.7 years were included in the study. Twenty-five patients received aflibercept and twenty-five received ranibizumab. BCVA was 40.8 +/- 10.0 and increased to 52.1 +/- 7.9 ETDRS letters at the last visit (p < 0.001). CRT was 295.6 +/- 34.0 at baseline and 247.9 +/- 29.7 at the last study visit (p < 0.001). SCP FAZ was 350.6 +/- 79.5 mu m(2) at baseline and 339.0 +/- 71.3 mu m(2) after sox monthly injections (p = 0.132). DCP FAZ was 558.6 +/- 199.0 mu m(2) at baseline and 459.5 +/- 156.1 mu m(2) after six monthly injections (p < 0.001). There was no effect of the choice of ranibizumab or aflibercept on DCP FAZ change (p = 0.277). In conclusion, treatment with 6 monthly injections of ranibizumab and aflibercept led to an increase in BCVA and a decrease in CRT and DCP FAZ area. Both drugs led to an improvement in DCP ischemia.