Title: An Overview of Intravitreal Aflibercept in Diabetic Macular Oedema
Abstract: Diabetic macular oedema (DMO) is responsible for much of the vision loss associated with diabetic retinopathy, which is the leading cause of blindness in working-age adults. Approximately 21 million people worldwide have DMO. The standard of care for DMO has been laser photocoagulation: this option has only a limited ability to reverse vision loss and is associated with a risk of scarring and complications. Corticosteroids have also been used in DMO treatment, but are associated with side effects such as elevated intraocular pressure and cataract. Knowledge of the role of vascular endothelial growth factor (VEGF) in the pathogenesis of DMO has led to the widespread use of anti-VEGF agents. Intravitreal bevacizumab, which is not approved for any retinal disorders, is used off-label for the treatment of DMO. Intravitreal ranibizumab (IVT-AFL) (once monthly) and intravitreal aflibercept (once every 2 months after a loading dose) have been approved for the treatment of DMO. This review summarises the clinical evidence supporting the role of IVT-AFL in the treatment of DMO. Analysis of efficacy and safety data suggests that aflibercept could be used as a first-line treatment in DMO.