Variable Interval Versus Set Interval Aflibercept for DME

Inclusion Criteria:

1. Adults 18 years and older with Type 1 or Type 2 diabetes mellitus

2. Patients with diabetic macular edema involving the center of the macular in the study
eye (CST must measure at least 350µm on Heidelberg SDOCT, or 333µm on Cirrus SDOCT)

3. Decrease in vision determined to be primarily due to DME in the study eye

4. BCVA ETDRS letter score 78 to 24 (20/32 to 20/320) in the study eye

5. Willing and able to comply with clinical visits and study related procedures

6. Willing and able to provide signed informed consent

Exclusion Criteria:

1. History of vitreoretinal surgery in the study eye

2. Laser photocoagulation (panretinal or macular) in the study eye within 90 days of
baseline

3. Previous use of intraocular or periocular corticosteroids in the study eye within 90
days of baseline

4. History of intravitreal anti-VEGF treatments in the study within 90days prior to
baseline (not including prior intravitreal aflibercept injection [see exclusion
criteria #5])

5. Any history of intravitreal aflibercept

6. Active proliferative diabetic retinopathy (PDR) in the study eye

7. History of idiopathic or autoimmune uveitis in the study eye

8. Cataract surgery in the study eye within 90 days of baseline

9. Aphakia in the study eye

10. Yttrium aluminum garnet (YAG) capsulotomy in the study eye within 30 days of baseline

11. Any intraocular surgery in the study eye within 90 days of day 1

12. Vitreomacular traction or epiretinal membrane in the study eye that is thought to
affect central vision

13. Current iris neovascularization, vitreous hemorrhage, or traction retinal detachment
in the study eye

14. Pre-retinal fibrosis involving the macula in the study eye

15. Uncontrolled glaucoma (defined as any patient who has had filtration surgery in the
past, or likely to need filtration surgery in the future, or has IOP ≥30mmHg)

16. Myopia of a spherical equivalent prior to any possible refractive or cataract surgery
of ≥-8 diopters

17. Concurrent disease in the study eye, other than DME, that could compromise BCVA,
require medical or surgical intervention during the study period, or could confound
interpretation of the results (including retinal vascular occlusion, retinal
detachment, macular hole, or choroidal neovascularization of any cause)

18. Ocular media of insufficient quality to obtain fundus and SDOCT images

19. Current treatment for a systemic infection

20. Administration of systemic anti-angiogenic agents within 180 days of baseline

21. Uncontrolled diabetes mellitus, in the opinion of the investigator

22. Uncontrolled blood pressure (define as systolic >180mmHg, or diastolic >110mmHg while
patient is sitting)

23. History of CVA or MI within 180 days of baseline

24. Renal failure requiring dialysis or renal transplant

25. Known serious allergy to fluorescein

26. Participation in an investigational study within 30 days prior to baseline that
involved treatment with any drug (excluding vitamins and minerals) or device

27. Any women who are pregnant, breast-feeding, or attempting to become pregnant

28. Sexually active men* or women of childbearing potential** who are unwilling to
practice adequate contraception during the study (adequate contraceptive measures
include stable use of oral contraceptives or other prescription pharmaceutical
contraceptives for 2 or more menstrual cycles prior to screening; intrauterine device
[IUD]; bilateral tubal ligation; vasectomy; condom plus contraceptive sponge, foam, or
jelly, or diaphragm plus contraceptive sponge, foam, or jelly) *Contraception is not
required for men with documented vasectomy. **Postmenopausal women must be amenorrheic
for at least 12 months in order not to be considered of child bearing potential.
Pregnancy testing and contraception are not required for women with documented
hysterectomy or tubal ligation.