Retrospective Analysis of Treatment Patterns in Pseudophakic Diabetic Macular Oedema Eyes Treated with Anti-VEGF.

Di Zou,Imran Jawaid,Winfried M Amoaku,Marcel Menke

doi:10.1155/2021/9967831

Abstract

Methods We performed a retrospective review of outcomes in 81 pseudophakic eyes with DMO that received at least 6 anti-VEGF injections. We reviewed baseline and posttreatment optical coherence tomography images, visual acuity, prescribing patterns, time taken to deliver anti-VEGF injections, and structural and functional outcomes. Results It took an average of 913 ± 454.1 days to deliver a mean of 11.1 ± 4.7 anti-VEGF injections. Time from baseline to receiving the first 6 anti-VEGF injections was longer than 9 months in 74.7% (n = 59/79) of eyes. There was a mean gain of 1.6 letters (−0.03 logMAR) from baseline to the end point. After 5 anti-VEGF intravitreal injections, the mean CMT was 391.9 μm from 474.4 μm at baseline (p < 0.0001). In 52 of 79 eyes (65.8%), more than one type of anti-VEGF agent was used. Conclusions The anti-VEGF treatment used to treat these eyes with DMO was suboptimal, a finding consistent with recently published “real-world” data. There was a strong tendency for patients to be switched within the class to a second anti-VEGF agent.

Highlights

In the UK, the prevalence of diabetes has increased from an estimated 2.8% in 1996 to 4.3% in 2005—an increase of more than 50% in 10 years [1]
Total number of eyes (n) Age Sex Eye treated Lens status Mean IVI received by N eyes Time to all injections Total IVI count (n) Ranibizumab Aflibercept Bevacizumab IVTA Best-recorded visual acuity (BRVA) central macular thickness (CMT) maximal macular thickness (MMT)
Ranibizumab was used as the first-line therapy in 90.4% of eyes (i.e., 47 of 52 eyes); aflibercept and bevacizumab were used as the first-line treatment in 2 and 3 eyes, respectively

Summary

Introduction

In the UK, the prevalence of diabetes has increased from an estimated 2.8% in 1996 to 4.3% in 2005—an increase of more than 50% in 10 years [1]. In the 20 years, it is projected that the population with diabetic retinopathy (DR) will increase by at least 20%, assuming age-specific prevalence rates remain constant. If prevalence rates increase in line with other Western countries, an increase of between 50 and 80% is projected [1]. Diabetic macular oedema (DMO) is a common, specific form of DR, which results from the accumulation of fluid into, and thickening of, the macula; it is one of the most common causes of vision loss in patients with diabetes [3]. Current therapeutic options for DMO in the UK include focal/grid laser photocoagulation; intravitreal injections (IVTs) of antivascular endothelial growth factor (anti-VEGF) drugs, including ranibizumab

Results

Discussion

Conclusion