Effect Of Intravitreal Injection Of Aflibercept Injection On Macular Structural And Functional Changes In The Treatment Of Different Types Of Diabetic Macular Edema

Objective:To investigate the effect of intravitreal injection of Aflibercept injection on macular structural and functional changes in the treatment of different types of diabetic macular edema Methods:Patients with diabetic retinopathy(DR)with DME diagnosed by fundus fundus angiography(FFA)from January 2022 to October 2022 in the ophthalmology department of The First Affiliated Hospital of Nanchang University were enrolled in a prospective study.All included patients had completed systemic examinations such as blood glucose,blood pressure,glycated hemoglobin(Hb A1C),etc.,routine ophthalmologic examinations including best corrected visual acuity(BCVA)and refraction,etc.,and special ophthalmologic examinations including optical coherence tomography(OCT),FFA and microperimetry(MP).According to the OCT image characteristics,patients with DME with different morphological manifestations were divided into three groups: group A with cystoid macular edema(CME),group B with diffuse retinal thickening(DRT),and group C with serous retinal detachment(SRD).Treatment regimen: 3+PRN with 6-month follow-up.The central macular thickness(CMT),mean sensitivity(MS),fixation rate(P1,P2),bivariate contour ellipse area(BCEA),and BCVA were collected before and after treatment in the three groups.(BCEA),BCVA,and other data were statistically analyzed.Results:1.Baseline data: There was no statistically significant difference in age,gender composition,eye category,duration of disease,intra ocular pressure,eye axis and Hb A1 C information when comparing the three groups(all P>0.05).2.Changes in visual acuity and CMT: Within-group: Compared with the pre-treatment period,patients in groups A,B and C showed improvement in BCVA and CMT after 3 months and after 6 months of treatment,and the differences were statistically significant(all P<0.05).After 6 months of treatment compared with after 3 months of treatment,CMT improved significantly in all three groups,but only BCVA improved in patients in group B.All of these differences were statistically significant(P<0.05),while BCVA did not change significantly in patients in groups A and C.The differences were not statistically significant(P>0.05).Comparison between groups: After 3 months of treatment,there was no statistically significant difference in the amount of change in BCVA among the three groups of patients(P>0.05);after 6 months of treatment,the amount of change in BCVA among the three groups of patients was compared: Group B had the most significant improvement in BCVA,and Group A had a significant improvement in BCVA compared with Group C.The differences were statistically significant(P<0.05).After 3 months and 6 months of treatment,the difference between groups was statistically significant(P<0.05)in the amount of change in CMT in the three groups.There was no statistically significant difference in the amount of change in BCVA and the magnitude of change in CMT between groups of patients in groups A,B and C from March to June of treatment(all P>0.05).3.Changes in MP:Within-group comparison: P1,P2,BCEA 68.2,BCEA 95.4,BCEA 99.6°,4°MS,8° MS and 12° MS improved in all three groups after 6 months of treatment compared to pre-treatment,all differences were statistically significant(p<0.05).Comparison between groups: After 6 months of treatment,the differences in the amount of change in P2,BCEA68.2,and BCEA99.6 were statistically significant in the three groups(all P<0.05).The improvement of P2 was more significant in group C compared with groups A and B.The improvement of BCEA68.2 and BCEA99.6was more significant in groups A and B compared with group C(all P<0.05).There was no statistically significant difference in the amount of change in P1,BCEA68.2,4°MS,8°MS and 12°MS among the three groups(all P>0.05).4.Correlation analysis: Pearson correlation analysis was performed for groups A,B and C.Baseline BCVA was positively correlated with treatment 6-month BCVA and baseline CMT with treatment 6-month CMT in groups A,B and C(all P<0.05).In addition,baseline BCVA in group A was positively correlated with treatment month 6 CMT(P<0.05)and baseline CMT was negatively correlated with treatment month 6 MS(P<0.05).baseline BCVA and baseline CMT in group B were both negatively correlated with treatment month 6 MS(P<0.05)and positively correlated with treatment month 6 BCEA(P<0.05).baseline BCVA in group C was negatively correlated with P1 and MS at baseline was negatively correlated with P1 and MS(both P<0.05)and positively correlated with BCEA at 6 months of treatment(both P<0.05).5.Number of injections: During the 6 months of treatment,the number of injections in group B was less than that in group C.The difference was statistically significant(P<0.05),but between groups A and C,and between groups A and B,the difference in the number of injections was not statistically significant(both P>0.05).Conclusions:1.Aflibercept intravitreal injection can effectively reduce macular retinal thickness in different types of DME,which plays a stabilizing and improving role in visual acuity and visual functions such as mean retinal sensitivity and fixation.2.DRT type DME is better than CME type and SRD type in terms of visual acuity improvement with Aflibercept intravitreal injection treatment.3.The combination of visual acuity,OCT and micro-vision helps to assess the full extent and efficacy of diabetic macular oedema lesions.