July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Effect of patient adherence to recommended treatments on functional outcomes following off-label intravitreal bevacizumab injections for diabetic macular edema
Author Affiliations & Notes
  • John O'Fee
    USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Eric Jung
    USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Nadim Rayess
    USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Andrew Moshfeghi
    USC Roski Eye Institute, Keck School of Medicine of USC, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   John O'Fee, None; Eric Jung, None; Nadim Rayess, None; Andrew Moshfeghi, Allegro (C), Allergan (C), EyePoint (C), Genentech (C), Genentech (F), National Eye Institute P30 grant # EY029220 from NIH (Bethesda, MD) (F), OptiSTENT (I), Pr3vent (I), Regeneron (C), Regeneron (F), Spark (C), Unrestricted Grant to the Department of Ophthalmology (USC) from Research to Prevent Blindness, New York, NY (F), Valeant (C), Visunex (C), Visunex (I)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1076. doi:
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      John O'Fee, Eric Jung, Nadim Rayess, Andrew Moshfeghi; Effect of patient adherence to recommended treatments on functional outcomes following off-label intravitreal bevacizumab injections for diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1076.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Non-attendance to hospital appointments has unfavorable effects on health outcomes. This retrospective study assessed the impact of patient adherence with appointments on functional outcomes in diabetic macular edema (DME) patients receiving anti-vascular endothelial growth factor (VEGF) injections in a county hospital setting.

Methods : Retrospective consecutive case series of treatment-naïve DME patients receiving off-label intravitreal bevacizumab injections at a county hospital. Patient adherence was defined as patients who maintained all appointments during a span of 6 months, whereas patient non-adherence was defined as patients who missed ≥ 1 appointment at 6 months. Outcomes were assessed at 6 months.

All patients included started receiving off-label intravitreal bevacizumab injections between January 1, 2015 and November 16, 2016. Required follow-up period was 6 months. Patients were excluded if they received prior anti-VEGF therapy or intravitreal/subtenon injection of steroids, pars plana vitrectomy (PPV) or focal/grid macular laser photocoagulation. In addition, patients who received cataract surgery during the time interval of follow up were excluded from the study.

Results : For the 6-month adherent group (42 eyes), mean baseline logMAR visual acuity (VA) was 0.67 (Snellen 20/94) and there was a trend towards improvement at 6 months follow-up at a mean logMAR VA of 0.56 (Snellen 20/74; P = .36). For the 6-month non-adherent group (29 eyes), mean baseline logMAR visual acuity (VA) was 0.52 (Snellen 20/66) and there did not appear to be improvement at 6 months follow-up at a mean logMAR VA of 0.51 (Snellen 20/65; P = .91).

The 6-month adherent group received an average of 2.96 +/- 1.34 injections. The 6-month non-adherent group received an average of 2.83 +/- 1.26 injections.

The 6-month adherent group received had an average longest interval without injection of 15.37 +/- 6.71 weeks. The 6-month non-adherent group had an average longest interval without injection of 16.03 +/- 6.73 weeks.

Conclusions : For 6 months, the adherent group gains 2 lines of VA whereas the non-adherent group does not seem to gain significant VA.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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