Patients with DME maintain visual acuity despite fewer injections
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DENVER — Patients with diabetic macular edema were able to maintain visual acuity improvements long term despite receiving fewer anti-VEGF injections as treatment progressed, according to a study.
At the Association for Research in Vision and Ophthalmology meeting, Blanche L. Kuo told Healio/OSN that previous studies have shown that real-world patients receive fewer anti-VEGF injections than participants in clinical trials.
“We wanted to look at a large data set... to look at what the real-world trends in diabetic macular edema are,” she said.
Using data from the IRIS Registry, the study authors conducted a retrospective analysis of 124,684 eyes of treatment-naive patients with DME who initiated anti-VEGF therapy between 2015 and 2019. Change in visual acuity from baseline and anti-VEGF injection frequency for up to 6 years of follow-up were recorded, while visual acuity outcomes were stratified by baseline acuity and number of injections for the given year.
At year 6, 1,235 eyes received a mean of 2.9 ± 2.1 injections at a mean interval of 12.3 ± 8.2 weeks. These patients gained a mean of 0.5 ± 19.7 letters from baseline in visual acuity.
Overall change in visual acuity at the end of follow-up was negative for eyes with initial visual acuity of 20/25 or greater and 20/25 to 20/40 and positive for eyes with initial visual acuity of 20/40 to 20/80, 20/80 to 20/200, and 20/200 or less.
When eyes were stratified by the average number of injections each year, change in visual acuity from baseline was +2.8 in those who received one to two injections compared with +4.8 in those who received at least 11 injections in the first year.
“We’re seeing that the majority of the visual changes are occurring in the first year, with the people with the worst starting VA gaining the most letters as a result of injections,” Kuo said. “Looking at the long-term data, we’re seeing that most of the VA changes are preserved after the first year. Those who gain up to 20 letters when they start with poor visual function are able to maintain those 20 letters even with fewer injections over the years.”
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Kuo BL, et al. Association of long-term visual outcomes and number of anti-VEGF injections in patients with diabetic macular edema in routine clinical practice: 6-year follow-up using the IRIS Registry. Presented at: Association for Research in Vision and Ophthalmology meeting; May 1-4, 2022; Denver.
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