Anti-VEGF pro re nata therapy in diabetic macular edema: a retrospective analysis of the number of injections applied in the first 2 years of treatment

Abstract

Background: Diabetic macular edema (DME) is one of the main causes of blindness worldwide. Intravitreal injections with anti-VEGF agents are the first-line treatment for central involved DME. In clinical trials treating DME with anti-VEGF good outcomes in visual acuity and central macular thickness were achieved with a high injection rate after treatment initiation. The aim of the following study was to evaluate the number of injections applied in the first two years, and its functional and anatomic outcomes, under real life conditions at the Department of Ophthalmology at Medical University of Graz. Design and methods: This study is a retrospective analysis on eyes of patients with diagnosed central involved DME at the Department of Ophthalmology at Medical University of Graz. receiving initial anti-VEGF treatment with Avastin between the 1.1.2014 and the 31.12.2015. Patients medical records were followed over two years. Outcome measures: Main outcome was to determine the number of intravitreal injections with Avastin® applied in eyes with intravitreal treatment-naive DME over two years, after treatment initiation. Secondary outcomes were the change in best corrected visual acuity (BVCA), central subfield thickness (CST), intraocular pressure and macular volume achieved after 1 year and 2 years. In addition, a separate analysis was conducted for the number of injections applied in eyes which received panretinal photocoagulation prior and during the study period. Results: Data of 157 eyes of 110 patients were analyzed for this study. The median number of injections over 2 years was 4, 37.58% received 3 injections and 53.5% received more than 3 injections. The median number of injections in the second year was 1. In only 50 eyes visits after one and during two years was recorded. Mean follow-up was 9.9 months over a 2-year surveillance period. Eyes which received panretinal photocoagulation prior or during the study period had a median of 5 injections. Mean BCVA increased from 0.45(+-0.23) to 0.53(+-0.25) (P-value

Datum der Bewilligung	2020
Originalsprache	Englisch
Gradverleihende Hochschule	Medizinische Universität Graz
Betreuer/-in	Andreas Wedrich (Betreuer*in) & Monja Michelitsch (Mitbetreuer*in)