Chinese experts consensus for the intravitreal injection of aflibercept treating diabetic macular edema (2021)

Author: Intravitreal Injection of Aflibercept for Diabetic Macular Edema Experts Consensus Group
DOI: 10.3760/cma.j.cn115989-20210202-00088
Published 2021-05-10
Cite asChin J Exp Ophthalmol, 2021, 39(5): 369-375.

Abstract                                            【Read Full Text】【Download PDF

Diabetic macular edema (DME) is one of the most common complications of diabetic retinopathy (DR). There was the largest number of diabetic patients in the world in China since 2017, and about 33.62% of Chinese DR patients suffer from DME.Therefore, it is very necessary to give effective management for DME as early as possible.In recent years, intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs and glucocorticoids has provided a novel treatment approach for DME patients.The inhibition of VEGF for treating DME has been widely tested in pivotal and comparative randomized controlled clinical trials.As far as we know, VEGF and placental growth factor (PGF) play a synergistic effect in the pathogenesis of DR/DME, and aflibercept can simultaneously inhibit these two factors after intravitreal injections.Aflibercept is a humanized fusion protein of VEGF receptor, and it can bind to all types of VEGF-A and PGF.The affinity of aflibercept is proved to be stronger, and the acting duration of aflibercept is confirmed to be longer following intravitreal injection in comparison with monoclonal antibody drugs.Clinical practices show that aflibercept can improve visual acuity for a long term and is well tolerated in DME patients.This drug has been approved to apply in ophthalmology in China, but there is still a great challenge in standardization of procedure in clinical practices.An expert proposal of intravitreal injections of aflibercept for DME is put forward and recommended based on the pathogenesis of DME, the pharmacological effects, regimes, dosage and safety of aflibercept, analysis and discussion of literature, and the clinical experience of leading experts in ophthalmology, which will provide a guidance for the reasonable application of aflibercept in the management of Chinese DME patients.

Key words:

Diabetes mellitus/complication; Diabetic macular edema; Vascular endothelial growth factor; Intravitreal injection; Efficacy; Safety; Expert consensus; Aflibercept

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Intravitreal Injection of Aflibercept for Diabetic Macular Edema Experts Consensus Group
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Updated: May 27, 2021 — 3:40 am