Treating diabetic retinopathy (DR) with anti-vascular endothelial growth factor (VEGF) agents is an alternative to panretinal laser, and in some studies it has been found that “significantly more eyes with diabetic macular edema (DME)” can have a ≥ 2-step improvement in diabetic retinopathy severity scores (DRSS) than in eyes treated with laser, according to Rishi Singh, MD, who presented on the topic earlier this year at the American Society of Retina Specialists meeting.
But clinicians need to know the average time needed before patients can achieve a sustained DRSS improvement. Equally important is understanding the benefits of achieving the benchmark, he said.
Presenting on behalf of the VISTA and VIVID study investigators, Dr. Singh reported on a post-hoc analysis of the aflibercept studies that aimed to assess the time to and proportion of eyes with DME that achieved a sustained ≥1-step and ≥2-step improvement in DRSS score, and to evaluate the visual benefits of achieving a sustained ≥2-step improvement in DRSS score compared with a sustained ≥1-step worsening in DRSS score.
(To briefly recap, VISTA and VIVID were two randomized, multicenter, double-masked trials of patients with clinically significant DME with central involvement and a best-corrected visual acuity [BCVA] of 20/40 to 20/320. Patients were randomized to either intravitreal aflibercept every 4 weeks, every 8 weeks, or to laser, the latter of which served as the control arm. A total of 872 patients were enrolled: 291 to laser, 292 to aflibercept every 4 weeks, and 289 to aflibercept every 8 weeks.)