Do eye injections reduce the risk of blindness in patients with severe diabetic eye disease?

This study looked at the use of aflibercept (Eylea) eye injections for the treatment of severe nonproliferative diabetic retinopathy (DR; diabetic eye disease). It found that more than half of the patients treated with aflibercept showed a significant improvement in DR after 6 months.

DR is one of the most common causes of blindness. It progresses through various stages. The most advanced stage is called proliferative diabetic retinopathy (PDR). In this stage new blood vessels start to form in the retina. PDR requires urgent laser treatment.

The stage immediately before PDR is called severe nonproliferative diabetic retinopathy (NPDR).  Severe NPDR is a high-risk stage of disease because it can quickly progress to PDR

Aflibercept is a drug that is injected into the eye to treat several conditions. It reduced the formation of new blood vessels. It is not clear if aflibercept can improve severe NPDR.

402 patients with diabetes and NPDR participated in this study. One eye from each patient was treated in the study. Patients were divided into three groups. Group 1 received aflibercept 2 mg 3 monthly injections, then 1 injection after 8 weeks, then injections every 16 weeks for 100 weeks. Group 2 received a different schedule of 2 mg aflibercept injections: 5 montly injections, then 4 injections every 8 weeks, then injections every 4 weeks or as required until the end of the study. Group 3 received placebo injections.

After 6 months, 58.4% of patients in groups 1 and 2 showed a significant improvement in DR compared to 6 % of patients in the placebo group. After 12 months, 65.% of group 1 patients and 79.9% of group 2 patients showed a significant improvement in DR, compared to 15% of the placebo group. After 100 weeks, vision-threatening complications were found in 16.3% of group 1 patients, 18.7% of group 2 patients, and 50.4% of the patients on placebo.

This study showed that aflibercept injections improve severe NPDR and reduce the risk of sight-threatening complications.

This study followed patients for 100 weeks. It would be useful to follow patients for even longer to see how this chronic condition responds to treatment over a longer time period. This study was funded by Regeneron Pharmaceuticals, the manufacturers of aflibercept. 

Speak to your physician about the possible role of aflibercept injections in your treatment for DR.