Intravitreal Aflibercept Injection in the Treatment of Diabetic Macular Edema: Chinese expert consensus (2021)

Title: Intravitreal Aflibercept Injection in the Treatment of Diabetic Macular Edema: Chinese expert consensus (2021)
Edition: Original
Classification: Experts consensus
Field: Treatment
Countries and regions: China
Guidelines users:
Evidence classification method:
Development unit: Peking Union Medical College Hospital, Chinese Academy of Medical Sciences
Registration time: 2021-01-07
Registration number: IPGRP-2021CN004
Purpose of the guideline: ] Diabetic macular edema (DME) is one of the most common complications of diabetic retinopathy (DR). Since 2017, China has had the largest number of diabetic patients in the world. About 33.62% of Chinese DR patients also suffer from DME, that is why the intervention of DME should be early and effective. Recently, intravitreal injection of anti-VEGF drugs and glucocorticoids has opened up a novel treatment approach for DME patients. The inhibition of vascular endothelial growth factor (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) have a synergistic effect in the pathogenesis of DR/DME, while aflibercept, a kind of anti-VEGF intravitreal injections, can simultaneously inhibit these two factors. The affinity of aflibercept and its inhibition time of intraocular VEGF have been proved about 100 times and twice than that of monoclonal antibodies, respectively. Aflibercept resulted in improvement in visual acuity with a long-term effects, and were well tolerated in DME patients. It has been approved in China, but there are still challenges for application in clinical practice. This expert consensus shall give an overview on the pathogenesis of DME, the pharmacological effects, regimes, dosage and safety of aflibercept, etc. The following guidance for the medication of aflibercept has been formed by analysis and discussion of literature, and the clinical experience of leading experts in ophthalmology, which may provide a helpful reference for the scientific application of aflibercept in Chinese DME patients.