Safety of intravitreal anti VEGF injections in diabetic macular edema

Abstract

Propose: Diabetic macular edema (DME) is the most common cause of visual impairment in patients with diabetes mellitus.The pathogenesis of DME is complex and multifactorial. DME can be diagnosed using noncontact stereoscopic biomicroscopy, contact lens biomicroscopy, Fundus fluorescein angiography (FFA), and Optical Coherence Tomography (OCT). Intravitreal anti-vascular endothelial growth factor (VEGF) agents have been investigated in the treatment of DME.This study aims to investigate the safety of intravitreal anti-VEGF during a six-month follow-up.Methods: Sixty patients with type I or II diabetes mellitus complaining from central involved DME were recruited for this longitudinal study. All patients were subjected to full history taking, complete ophthalmological examination, systemic evaluation, FFA, and OCT imaging. Patients were subdivided into three groups, 20 patients each: Ranibizumab group, Bevacizumab group, and Aflibercept group.Results: After 6-month follow-up, the ranibizumab group showed slightly higher systemic cardiovascular and cerebrovascular accidents rates, while the Bevacizumab group showed insignificant higher risk of ocular inflammation and endophthalmitis, aflibercept has the least incidence of ocular adverse effects. Conclusion:Anti-VEGF intravitreal injections are relatively safe for the treatment of DME. Aflibercept showed the least incidence of ocular side effects. The current study suggested that intravitreal anti-VEGF could be administered safely to diabetic patients with decreased glomerular filtration rate (GFR).