One-Year Anti-VEGF Therapy Outcomes in Diabetic Macular Edema Based on Treatment Intensity

Purpose

To compare 1-year outcomes of eyes with diabetic macular edema (DME) treated in routine clinical practice based on the proportion of visits where intravitreal VEGF inhibitor injections were delivered.

Design

Cohort study.

Participants

There were 2288 treatment-naive eyes with DME starting intravitreal VEGF inhibitor therapy from October 31, 2015 to October 31, 2021 from the Fight Retinal Blindness! international outcomes registry.

Methods

Eyes were grouped according to the proportion of visits at which an injection was received, Group A with less than the median of 67% (n = 1172) versus Group B with greater than the median (n = 1116).

Main Outcome Measures

Mean visual acuity (VA) change after 12 months of treatment.

Results

The mean (95% confidence interval [CI]) VA change after 12 months of treatment was 3.6 (2.8–4.4) letters for eyes in Group A versus 5.2 (4.4–5.9) letters for eyes in Group B (P = 0.005). The mean (95% CI) central subfield thickness (CST) change was −69 (−76 to −61) μm and −85 (−92 to −78) μm for eyes in Group A versus Group B, respectively (P = 0.002). A moderate positive correlation was observed between the number of injections received over 12 months of treatment and the change in VA (P < 0.001). Additionally, eyes that received more injections had a moderately greater CST reduction.

Conclusions

This registry analysis found that overall VA and anatomic outcomes tended to be better in DME eyes treated at a greater proportion of visits in the first year of intravitreal VEGF inhibitor therapy.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.