Treatment With Intravitreal Aflibercept Injection For Proliferative Diabetic Retinopathy, The A.C.T Study

Inclusion Criteria: Subjects will be enrolled if the following criteria are met:

• Ability to provide written informed consent and comply with study assessments for thefull duration of the study

• Age 18 years and older

• Retinal neovascularization secondary to diabetic retinopathy

• Best corrected visual acuity in the study eye better than 20/320 using an ETDRS chart

• In the event that either eye of a potential subject meets enrollment criteria, theworse sighted eye will be enrolled into the study. Only one eye can be enrolled in thestudy.

Exclusion Criteria:

• Pregnant or breast-feeding women Sexually active men* or women of childbearingpotential** who are unwilling to practice adequate contraception during the study andfor at least 30 days after the last administration of study drug for women and atleast 90 days after the last administration for men (adequate contraceptive measuresinclude stable use of oral contraceptives or other prescription pharmaceuticalcontraceptives for 2 or more menstrual cycles prior to screening; intrauterine device [IUD];; vasectomy; condom plus contraceptive sponge, foam, or jelly, or diaphragm pluscontraceptive sponge, foam, or jelly)

*Contraception is not required for men with documented vasectomy.

** Pregnancy testing and contraception are not required for women with documentedhysterectomy.

• HbA1C >10 within approximately 90 days of Screening visit

• Participation in a study of an investigational drug or device within 30 days prior topotential enrollment into the study

• Prior treatment with systemic anti-VEGF agents

• Presence of any substantial ocular disease (other than diabetic retinopathy) that maycompromise vision in the study eye and /or confound interpretation of the data; e.g.substantial cataracts, advanced glaucoma, optic neuritis, optic neuropathy or atrophy,marked macular atrophy, ocular vascular occlusion, history of retinal detachment,uveitis, viral or other forms of chorioretinitis, etc.

• Prior treatment with anti-VEGF therapy in the study eye within 90 days of baseline

• Prior treatment with PRP within 60 days

• Prior treatment with IAI.

• Prior treatment with triamcinolone in the study eye within 180 days of baseline.

• Prior treatment with dexamethasone in the study eye within 30 days prior to baseline.

• Intraocular surgery (including cataract surgery) in the study eye within 60 dayspreceding baseline

• History of vitrectomy surgery in the study eye.

• Active intraocular inflammation (grade trace or above) in the study eye

• History of rhegmatogenous retinal detachment or macular hole (Stage 3 or 4) in thestudy eye

• Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in eithereye

• Uncontrolled glaucoma in the study eye (defined as IOP ≥ 25 mmHg despite treatmentwith anti-glaucoma medication)

• History of cerebral vascular accident, myocardial infarction, transient ischemicattacks within 180 days of study enrollment.

• History of allergy to fluorescein, topical antibiotic, povidone iodine (Betadine) oraflibercept.

• Presence of vitreous hemorrhage that completely obstructs the view of the optic nerve (amount of vitreous hemorrhage will also be gated by 20/320 criteria)

• Presence of TRD in the study eye.

• Presence of pre-retinal fibrosis (not including epiretinal membrane)

• Unwilling to discontinue sperm bank donation for any period of time after IAItreatment