• Home
  • Research papers
  • Changes in metamorphopsia after intravitreal injection of aflibercept for diabetic macular edema

Changes in metamorphopsia after intravitreal injection of aflibercept for diabetic macular edema

By on October 17, 2022 0

We included 20 eyes of 20 patients with DME. Table 1 lists the basic clinical features. The average number of injections was 6.7 ± 1.2. No significant adverse events, including endophthalmitis, DR, or cataract development, were observed during the study period. During the follow-up period, none of the patients underwent cataract surgery.

Table 1 Basic clinical characteristics.

Changes in visual functions

Significant metamorphopsia (score ≥ 0.2) was detected in 10 out of 20 eyes before treatment and in 4 out of 20 eyes 12 months after treatment. The percentage of patients with significant metamorphopsia decreased significantly between before treatment and 12 months after treatment (p

Figure 1

Metamorphopsia Score Changes (A), best correlated visual acuity (BCVA) (B) and central foveal thickness (CFT) (VS) from baseline in eyes treated with intravitreal injection of aflibercept (IVA) for diabetic macular edema (DME). Error bars indicate standard deviations. Statistically significant from baseline (*p †p‡p §p

A subgroup analysis of ten patients who had significant metamorphopsia (score ≥ 0.2) before treatment revealed that mean metamorphopsia scores before treatment and at 1, 2, 3, 6, and 12 months after treatment were 0.45 ± 0.13, 0.30 ± 0.12, 0.30 ± 0.27, 0.24 ± 0.16, 0.20 ± 0.19 and 0.19 ± 0.20, respectively. Metamorphopsia scores were significantly improved at 1, 3, 6 and 12 months after treatment compared to those before treatment. (p

Figure 2
Figure 2

Changes in metamorphopsia scores of patients with diabetic macular edema (DME) with metamorphopsia at baseline. Error bars indicate standard deviations. Statistically significant from baseline (*p †p

ERM was observed in two patients. A subgroup analysis of 18 patients without ERM revealed that the mean metamorphopsia scores before treatment and at 1, 2, 3, 6 and 12 months after treatment were 0.23 ± 0.20, 0.20 ±0.15, 0.17 ±0.23, 0.11 ±0.14, 0.13 ±0.16, and 0.07 ±0.13, respectively. Metamorphopsia scores were significantly better at 3 and 12 months after treatment than before treatment. (p

figure 3
figure 3

Changes in metamorphopsia scores of patients without an epiretinal membrane. Error bars indicate standard deviations. Statistically significant from baseline (*p †p

Relationship between metamorphopsia and visual acuity

The metamorphopsia score before treatment was not significantly correlated with BCVA before treatment (r = 0.031, p = 0.896). Metamorphopsia score 12 months after treatment was also not significantly correlated with BCVA (r = 0.085, P = 0.721).

Relationship between visual functions and OCT results

The association between visual functions and pretreatment OCT results is shown in Table 2. OCT parameters were not significantly associated with mean metamorphopsia score. The BCVA of eyes with an outer limiting membrane (ELM) grade 0, grade 1, and grade 2 were 0.21 ± 0.18, 0.42 ± 0.26, and 1.13 ± 0.04, respectively, and MLE status was significantly associated with BCVA (p = 0.018). BCVA of eyes with grade 0, grade 1 and grade 2 ellipsoid zone (EZ) were 0.10 ± 0.00, 0.33 ± 0.24 and 0.81 ± 0.40, respectively, and EZ status was significantly associated with BCVA (p=0.042). Other OCT findings were not associated with BCVA.

Table 2 Correlations between visual functions and OCT results before treatment.

The association between visual functions and OCT results when macular edema was resolved is shown in Table 3. In 13 eyes, DME was most resolved 12 months after treatment. In four eyes, DME was most resolved 9 months after treatment. In three eyes, DME was most resolved 6 months after treatment. ERM was observed in two patients. Mean eye metamorphopsia with ERM and without ERM was 0.35 ± 0.35 and 0.05 ± 0.11, respectively, and the presence of ERM was significantly correlated with the mean metamorphopsia score (p = 0.036) , while the other parameters were not correlated.

Table 3 Correlations between visual functions and OCT results when macular edema was largely resolved.