Design of study: Three months prospective interventional study. Purpose: To evaluate changes in retinal arterial and venous oxygen saturation after intravitreal aflibercept in patients with diabetic macular edema (DME). Methods: We included 17 patients with DME, central retinal thickness (CRT) >300 µm and no active proliferative diabetic retinopathy. Previous treatment with any intravitreal anti-VEGF agent was not allowed within 4 months prior to inclusion. All patients received 3 monthly intravitreal injections of aflibercept and retinal oximetry was performed at baseline and four weeks after the last injection. Retinal oxygen saturation was measured in 50-degree disc-centered images using the Oxymap model T1 (Oxymap, Reykjavik, Iceland). Global measures are presented as the average saturation of the four major arterioles and venules from the four quadrants. For macular measurements, we used the first traceable macular branches of the superior and inferior temporal arcades with a diameter >6µm. Paired t-test was used to test for differences in mean oxygen saturations from baseline to follow-up. Results: Median age and duration of diabetes were 59.5 and 2.6 years at baseline. Median HbA1c was 65 mmol/mol, and 23.5% were women. The global venous oxygen saturation increased from baseline to follow-up (62.3% vs. 65.7%, p=0.03), whereas the global arterial oxygen saturation was unchanged (98.4 vs. 98.4, p=0.98). For macular measures there was no difference in retinal oxygen saturations from baseline to follow-up in neither arterioles nor venules (95.6% vs. 95.0, p=0.68) (75.0% vs 76.8% p=0.21). Conclusion: Global venous oxygen saturation increases after treatment with 3 monthly intravitreal injections of aflibercept in patients with DME, whereas no difference was found in global arterial oxygen saturation or in macular measures. Our results correspond well with previous findings that metabolic changes in the retinal vasculature due to treatment of diabetic retinopathy and maculopathy are predominantly demonstrated on the venular side. Retinal oximetry may become an important non-invasive marker of disease activity and response to therapy. However, larger studies are needed to confirm this hypothesis.
|Tidsskrift||European Journal of Ophthalmology|
|Status||Udgivet - 2017|
|Begivenhed||27th Meeting of the European Association for the Study of Diabetes Eye Complications Study Group - Danubius Health Spa Resort Margitsziget Island, Budapest, Ungarn|
Varighed: 25. maj 2017 → 27. maj 2017
|Konference||27th Meeting of the European Association for the Study of Diabetes Eye Complications Study Group|
|Lokation||Danubius Health Spa Resort Margitsziget Island|
|Periode||25/05/2017 → 27/05/2017|
Blindbæk, S. L., Peto, T., & Grauslund, J. (2017). Changes in retinal oxygen saturation after intravitreal aflibercept in patients with diabetic macular edema. European Journal of Ophthalmology, 3(27), e120.