Journal
BRITISH JOURNAL OF OPHTHALMOLOGY
Volume 105, Issue 2, Pages 216-221Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bjophthalmol-2020-315933
Keywords
treatment medical; retina; macula
Categories
Ask authors/readers for more resources
The study evaluated visual acuity outcomes and anti-vascular endothelial growth factor (anti-VEGF) treatment intensity in diabetic macular oedema (DMO) patients. Patients with better baseline visual acuity may experience loss of vision at 1 year, while those with moderately severe baseline impairment could improve with more injections. Visual outcomes are correlated with treatment intensity at 1 year.
Background/Aim To assess visual acuity (VA) outcomes and antivascular endothelial growth factor (anti-VEGF) treatment intensity in diabetic macular oedema (DMO). Methods Retrospective analysis was performed in treatment-naive patients with DMO from 2013 to 2018 using a database of aggregated de-identified electronic medical records (Vestrum Health). Results At 1 year, 28 658 patient eyes underwent a mean of 6.4 anti-VEGF injections, gaining a mean of +4.2 letters (95% confidence interval for mean gain: +4.0 to +4.5 letters, p<0.001). When stratified by anti-VEGF medication and by years 2013-2018, no clinically meaningful differences in injection frequency or 1-year VA change resulted. At 1 year, 50% of eyes received <= 6 injections, while <20% received 10-13 injections, representing monthly treatment. Mean letters gained at 1 year generally showed a linear relationship with mean number of anti-VEGF injections, beyond two injections. Eyes with good baseline VA (>= 20/40) generally were at risk of VA loss at 1 year; those with moderately severe baseline impairment (20/70 to 20/200) who received >= 10 injections improved by a mean of +10.3 letters. Conclusion In clinical practice, patients with DMO undergo fewer anti-VEGF injections and exhibit worse visual gains compared with patients in randomised clinical trials. Visual outcomes correlate with treatment intensity at 1 year, with ceiling effects related to baseline VA.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available