Functional outcomes of sustained improvement on Diabetic Retinopathy Severity Scale with intravitreal aflibercept in the VISTA and VIVID trials

• Published in: Eye (London) 2023-07, Vol.37 (10), p.2020-2025
• Main Authors: Dhoot, Dilsher S., Moini, Hadi, Reed, Kimberly, Du, Weiming, Vitti, Robert, Berliner, Alyson J., Singh, Rishi P.
• Format: Article
• Language: English
• Subjects: 692/699/3161/3164; 692/699/3161/3175; Acuity; Angiogenesis Inhibitors - therapeutic use; Clinical Trials as Topic; Diabetes; Diabetes Mellitus; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - drug therapy; Diabetic Retinopathy - surgery; Edema; Eye; Humans; Intravitreal Injections; Laboratory Medicine; Laser Coagulation - adverse effects; Lasers; Macular Edema - diagnosis; Macular Edema - drug therapy; Macular Edema - surgery; Medicine; Medicine & Public Health; Ophthalmology; Pharmaceutical Sciences/Technology; Receptors, Vascular Endothelial Growth Factor - therapeutic use; Recombinant Fusion Proteins - therapeutic use; Retinopathy; Surgery; Surgical Oncology; Tomography, Optical Coherence; Treatment Outcome; Vascular Endothelial Growth Factor A - therapeutic use
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-022-02058-7

Aims To assess time to, cumulative incidence of, and functional benefit of achieving sustained ≥2-step Diabetic Retinopathy Severity Scale (DRSS) improvement in diabetic macular oedema (DMO). Methods Post hoc analysis of VISTA/VIVID including eyes with DMO treated with intravitreal aflibercept injections (IAI), 2 mg q4 weeks (2q4, n  = 250) or q8 weeks after 5 monthly doses (2q8, n  = 249), or laser control ( n  = 249). Changes from baseline in best-corrected visual acuity (BCVA) and central subfield thickness (CST) were evaluated in sustained (≥2 consecutive visits) DRSS subgroups (≥1-step worsening, no change, ≥2-step improvement). Results Time to sustained ≥2-step DRSS improvement was shorter for both the IAI 2q4 and IAI 2q8 groups versus laser (both log-rank p