The VISTA and VIVID randomised phase 3 trial were designed to compare the efficacy and safety of intravitreal aflibercept injections versus laser photocoagulation for diabetic macular oedema (DMO). A total of 872 patients with centrally involving DMO were recruited, and those randomised to aflibercept either had 2mg injected every four weeks or every eight weeks after five monthly doses. Intravitreal aflibercept was superior to laser both in terms of visual and anatomic outcomes at 52 weeks; the benefit was sustained through to week 100. The commonest adverse event was cataract (2.4% for the four-weekly injections and 1.0% for the eight-weekly injections). The ability to control DMO with eight-weekly injections over the longer term will hopefully help to ease some of the workload in retina and injection clinics. 

Intravitreal aflibercept for diabetic macular edema. 100-week results from the VISTA and VIVID studies.
Brown DM, Schmidt-Erfuth U, Do DV, et al.
OPHTHALMOLOGY
2015;122:2044-52.
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Brian Ang

Royal Victorian Eye and Ear Hospital, Melbourne, Australia

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