Effects of Intravitreal Injection of Aflibercept Combined with Laser Photocoagulation on Visual Function and Prognosis of Patients with Diabetic Macular Edema
LIU Zhen-tong, QIN Hong, TIAN Nan-nan
Eye Hospital, China Academy of Chinese Medical Sciences, Beijing 100040 China
Abstract：【Objective】To explore the effects of intravitreal injection of aflibercept combined with laser photocoagulation on visual function and prognosis of patients with diabetic macular edema (DME). 【Methods】From June 2018 to December 2018, 86 patients with DME in our hospital were selected as the research objects and were divided into the control group and the observation group according to the random number table method, with 43 cases in each group. Control group was given intravitreal injection of ranibizumab while observation group was given intravitreal injection of aflibercept; and all patients in the two groups received laser photocoagulation after 1～2 weeks of intravitreal injection. The clinical efficacy and occurrence of adverse events were recorded in the two groups, and the central macular foveal thickness (CMT), intraocular pressure and visual acuity of different baseline vision [best corrected visual acuity (BCVA)] were compared between the two groups before treatment and after 4 weeks and 12 weeks of treatment. The quality of life [quality of life scale for patients with visual functional lesions (SQOL-DVI)] was evaluated before treatment and after 24 weeks of treatment. 【Results】The clinical efficacy in observation group was significantly higher than that in control group (P<0.05). There was no significant difference in the occurrence of adverse events between the two groups (P>0.05). The comparison of CMT before and after treatment in the two groups showed CMT before treatment> at 4 weeks of treatment> at 12 weeks of treatment (P<0.05). And at 4 and 12 weeks of treatment, the CMT in observation group was lower than that in control group (P<0.05). There was no statistically significant difference in the intraocular pressure between the two groups and within the groups at different time points before and after treatment (P>0.05). The comparison of BCVA before and after treatment in the two groups with better baseline vision showed BCVA before treatment> at 4 weeks of treatment> at 12 weeks of treatment (P<0.05). But there was no significant difference between the two groups (P>0.05). The comparison of BCVA before and after treatment in the two groups with poorer baseline vision showed BCVA before treatment> at 4 weeks of treatment> at 12 weeks of treatment (P<0.05). And at 4 weeks and 12 weeks of treatment, the BCVA in the observation group was lower than that in control group (P<0.05). After 24 weeks of treatment, the scores of dimensions of clinical symptoms and visual function, somatic function, social activity and psychophysiology of SQOL-DVI in the two groups were increased compared with those before treatment (P<0.05), and the scores in observation group were higher than those in control group (P<0.05) . 【Conclusion】Laser photocoagulation combined with intravitreal injection of aflibercept is more advantageous for the treatment of DME with poor baseline vision. It can effectively improve the visual function of patients and enhance the prognosis and quality of life, with few adverse reactions and high clinical application value.
刘振通, 秦虹, 田楠楠. 阿柏西普玻璃体内注射联合激光光凝治疗糖尿病性黄斑水肿的临床疗效[J]. 医学临床研究, 2021, 38(9): 1292-1295.
LIU Zhen-tong, QIN Hong, TIAN Nan-nan. Effects of Intravitreal Injection of Aflibercept Combined with Laser Photocoagulation on Visual Function and Prognosis of Patients with Diabetic Macular Edema. JOURNAL OF CLINICAL RESEARCH, 2021, 38(9): 1292-1295.
[1] ASHRAF M,KAYAL H E,SOUKA A A R.Safety and efficacy of ziv-aflibercept in the treatment of refractory diabetic macular edema[J].Ophthalmic Surg Lasers Imaging Retina,2017,48(5):399-405. [2] HOLEKAMP N M,CAMPBELL J,ALMONY A,et al.Vision Outcomes following anti-vascular endothelial growth factor treatment of diabetic macular edema in clinical practice[J].Am J Ophthalmol,2018,191(4):83-91. [3] ALNAGDY A A.Impact of topical nonsteroidal anti-inflammatory drugs in prevention of macular edema following cataract surgery in diabetic patients[J].Int J Ophthalmol,2018,11(4):616-622. [4] MINAMI S,NAGAI N,SUZUKI M,et al.Benefits of aflibercept treatment for age-related macular degeneration patients with good best-corrected visual acuity at baseline[J].Sci Rep,2018,8(1):58-65. [5] NATHAN D M,BUSE J B,DAVIDSON M B,et al.Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the american diabetes association and the european association for the study of diabetes[J].Clin Ther,2007,29(1):139-153. [6] 陈凯,周洪伟.激光光凝联合雷珠单抗治疗糖尿病性黄斑水肿[J].国际眼科杂志,2019,19(9):1598-1601. [7] 李红,宋艳萍.糖尿病黄斑水肿患者视网膜敏感度和最佳矫正视力与黄斑中心凹视网膜厚度的相关性分析[J].中华眼底病杂志,2018,34(4):333-337. [8] 甘亚平,陈玲,韦晓丹,等.循证护理对糖尿病视网膜病变患者生活质量的影响[J].中华现代护理杂志,2019,25(8):1026-1029. [9] MIN J K,LEE S,PARK J H,et al.Effects of intravitreal aflibercept and ranibizumab on retinal vessel diameter measured using fluorescein angiography[J].Acta Ophthalmol,2018,96(4):546-547. [10] BANSAL A,BHENDE M,SHARMA T,et al.Aflibercept for recurrent or recalcitrant polypoidal choroidal vasculopathy in Indian eyes: Early experience[J].Indian J Ophthalmol,2018,66(2):349-350. [11] NAGAI N,IBUKI M,SHINODA H,et al.Maculopapular rash after intravitreal injection of an antivascular endothelial growth factor, aflibercept, for treating age-related macular degeneration[J].Medicine,2017,96(21):6965-6968.
2021, Vol. 38 
