Longitudinal Quantitative Ultrawidefield Angiographic Features in Diabetic Retinopathy Treated with Aflibercept from the Intravitreal Aflibercept as Indicated by Real-Time Objective Imaging to Achieve Diabetic Retinopathy Improvement Trial

Ophthalmology. Retina(2023)

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Forty eyes from 40 subjects with DR were enrolled. Lower baseline generalized leakage was noted in eyes that attained the 2-step DRSS improvement in less than 16 weeks (1.9% vs 2.8%, p=0.026). Baseline macular perivascular-generalized leakage ratio had a significant correlation with the number of treatment-free days (R=0.4, p=0.012). At the end of 1 year, therapy significantly reduced the mean panretinal (3.9% vs 5.8%, p=0.002) and macular (6.2% vs 12.2%, p=0.008) generalized leakage indices compared to baseline, as well as the mean panretinal perivascular leakage index (1.5% vs 2.3%, p=0.002). Mean panretinal ischemic index demonstrated a small but likely clinically insignificant decrease from 12.5% at baseline to 11.6% at year 1 (p=0.016) CONCLUSIONS: Down-trending leakage indices and microaneurysm counts were demonstrated over 1 year of anti-VEGF therapy. At baseline, DR eyes with lower generalized leakage responded to therapy more rapidly. Eyes with greater perivascular leakage relative to generalized leakage showed a longer lasting anti-VEGF treatment response.
Aflibercept,Diabetic retinopathy,Machine learning,Microaneurysm count,Ultra-widefield fluorescein angiography
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