{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:59:43Z","timestamp":1793401183391,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    <jats:bold>Purpose:<\/jats:bold>\n                    To assess clinical outcomes in diabetic macular edema (DME) patients treated with high-dose aflibercept 8.0 mg (HDA), focusing on treatment intervals, anatomic changes, and best-corrected visual acuity (BCVA).\n                    <jats:bold>Methods:<\/jats:bold>\n                    This retrospective, single-center study included 67 DME patients (100 eyes) treated at Cole Eye Institute between August 2023 and November 2024. All patients received at least 3 HDA injections, with a true loading dose defined as 3 initial injections given \u22645 weeks apart. The primary outcome was proportion of eyes for which minimum \u22657-week treatment intervals were maintained. Secondary outcomes included changes in BCVA, central subfield thickness (CST), and macular fluid status.\n                    <jats:bold>Results:<\/jats:bold>\n                    Loading dose was completed in 73 eyes (73%) and not completed in 27 eyes (27%). Before HDA injections, 4.0% of eyes were anti\u2013vascular endothelial growth factor naive. Mean (\u00b1SD) follow-up was 24.3 \u00b1 5.0 weeks. From baseline to final visit, mean (\u00b1SD) CST significantly decreased (from 371.1 \u00b1 134.6 \u03bcm to 330.0 \u00b1 121.7 \u03bcm;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .025), while BCVA remained stable (from 62.4 \u00b1 18.8 to 63.5 \u00b1 17.7 ETDRS letters;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .676). For 32 eyes (32%), \u22657-week treatment intervals could not be maintained, with 18 eyes being switched to alternative therapy and 14 eyes requiring &lt;7-week injection intervals; these eyes had significantly higher baseline CST (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .045). Persistent macular fluid was observed in 90% of eyes.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    HDA reduced CST and stabilized BCVA in DME patients. However, remaining challenges include frequent injections and persistent macular fluid, underscoring the chronic, treatment-resistant nature of DME and need for optimized treatment strategies.\n                  <\/jats:p>","DOI":"10.1177\/24741264251376918","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T09:25:56Z","timestamp":1759569956000},"page":"74-82","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Real-World Functional and Anatomic Outcomes With Aflibercept 8.0 mg in Patients With Diabetic Macular Edema"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3169-1097","authenticated-orcid":false,"given":"Gabriel Castilho S.","family":"Barbosa","sequence":"first","affiliation":[{"name":"Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA"},{"name":"Department of Ophthalmology, University of S\u00e3o Paulo, 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