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Adam Van Horn, Lilia Verchinina, Michele Wichorek, Dorene Markel, Thomas W. Gardner, Anjali Shah; Predictors of Anti-VEGF Treatment Initiation and Frequency in Diabetic Patients. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1891.
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Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are commonly used in the treatment of diabetic retinopathy (DR), but their frequency of administration varies considerably amongst patients. In addition, there is no way to predict which diabetics will require treatment. This study aims to identify the factors associated with whether or not diabetic patients receive anti-VEGF injections, as well as the frequency with which they are received.
Retrospective analysis was performed using data collected from 2382 diabetic patients who presented to the retina clinic at the Kellogg Eye Center over a 1-year period. 521 patients received at least 1 anti-VEGF injection. Logistic regression was used to identify demographic and medical factors associated with receiving at least one injection. Negative binomial regression was used to model the number of anti-VEGF injections.
See Table 1 and Table 2.
Among diabetic patients: age, maximum diastolic blood pressure, maximum systolic blood pressure, White/Caucasian race (versus Asian race), established diagnosis of diabetic eye disease (versus no such diagnosis), and type 2 diabetes (versus type 1) are statistically significant predictors of receiving at least 1 anti-VEGF injection over a 1-year period. Patient’s race (Unknown/Other/Mixed versus Asian), age, and type 2 diabetes (versus type 1) are statistically significantly associated with frequency of injections in a 1-year period. Interestingly, hemoglobin A1c and duration of diabetes - known risk factors for development and progression of DR - are not statistically significantly associated with either receiving injections or their frequency. This suggests that factors that put patients at risk for developing DR may not be the same as those that dictate need for treatment. Further research will allow us to better risk stratify diabetic patients who are most likely to need intensive treatment.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Table 1. Logistic Regression Model for Predicting Receiving at Least 1 Anti-VEGF Injection. * Denotes statistically significant predictors of receiving at least 1 injection over a 1-year period at alpha=.05.
Table 2. Negative Binomial Regression Predicting the Number of Anti-VEGF Injections. * Denotes statistically significant predictors of receiving an increased number of injections over a 1-year period at alpha= .05.
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