REAL LIFE VISUAL ACUITY OUTCOMES FOR PATIENTS TREATED WITH ANTI-VEGF FOR DIABETIC MACULAR OEDEMA IN A TERTIARY REFERRAL CENTER

Abstract

Purpose : The frequency of intravitreal anti-VEGF treatments for diabetic macular oedema (DMO) in real-life clinical settings is reported to be less than in pivotal studies. In light of this, there is increasing controversy as to what extent this practice compromises functional outcomes in everyday clinic patient cohorts. We performed a retrospective data-warehouse study to observe visual outcomes in eyes undergoing intravitreal therapy for DMO in a real-life setting.

Methods : A data-warehouse query for all eyes receiving receiving intravitreal injections for DMO between March 2013 and October 2018 was performed. Treatment frequency and visual outcomes, reported in Early Treatment Diabetic Retinopathy Study (ETDRS) letters, were analyzed for a observation period of four years in total. Means of non-parametric groups were compared to baseline using Wilcoxon Signed-rank test.

Results : At baseline, 2549 eyes of 1919 patients were included in the study cohort. The mean number of anti-VEGF injections delivered per eye was 7.8±2.0, 12.0±3.8, 16.0±6.0, and 20.0±7.0 at 12, 24, 36, and 48 months. Mean baseline visual acuity of our cohort was 61.0±15.3 ETDRS letters before initiating treatment. Visual acuity observed after 12, 24, 36 and 48 months was 65.6±16.2, 65.6±16.1, 63.8±17.3 and 61.1±18.8 letters, respectively. Improvement in visual acuity was statistically significant after 12, 24 and 36 months (all p<0.01) (Figure 1).

Conclusions : Randomized clinical trials achieve better results than real-life data with a higher number of administered injections per eye. Even though, intravitreal Anti-VEGF is an effective long term treatment for DMO patients to achieve and maintain respectable visual acuity in a real life setting. Patients undergoing long term treatment received a higher amount of injection in year one followed by a mean of 4 injection in year two, three and four.

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

 

Figure 1. Mean absolute visual acuity and mean change in visual acuity from baseline (ETDRS letters) over 48 month observation period. Error bars represent 95% confidence intervals of the mean. Pairwise comparison of baseline visual acuity to each time-point following baseline was used to calculate p-values: *** indicates p < 0.05 when compared with mean baseline visual acuity; nns denotes p > 0.05 (i.e. not-significant).