Intravitreal aflibercept partially reverses severe non-proliferative diabetic retinopathy in treatment-naive patients

Objective: To evaluate whether diabetic retinopathy can be reversed after aflibercept, based on improvements in diabetic macular edema, hard exudates (HEs) of the posterior pole, and retinal microaneurysms (MAs). Methods: This was a single-center retrospective study of 30 patients (34 eyes) with severe non-proliferative diabetic retinopathy (NPDR) who were treated between August and October 2018. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), area of HEs, and number of MAs were compared before and after treatment. Results: The mean patient age was 61.4 +/- 7.1 years; 14 patients (46.7%) were men. The mean number of injections per patient was 3.5 +/- 0.5. The time between the last injection and the last follow-up was 82 days (range, 78-110 days). Six months after the first intravitreal injection, significant improvement was observed in BCVA (from 0.70 +/- 0.18 to 0.42 +/- 0.19 logMAR), CFT (from 377.17 +/- 60.41 to 261.21 +/- 31.50 mu m), and number of MAs (from 182.2 +/- 77.4 to 101.5 +/- 59.6). Observations over 6 months after the first intravitreal injection showed a statistically significant reduction in the area of HEs (P = 0.007). No adverse events occurred during the treatment period. Conclusion: Diabetic retinopathy might be partially reversed by aflibercept treatment, as indicated by BCVA, CFT, number of MAs, and area of HEs.