Abstract
Purpose :
Intravitreal therapy (IVT) with anti-vascular endothelial growth factor (anti-VEGF) is first line treatment for diabetic macular edema (DME). This study describes anti-VEGF IVT frequency and long-term visual outcomes among DME patients in routine clinical practice in the United States.
Methods :
A retrospective analysis was performed among treatment-naïve DME patients (no prior IVT in the past 12 months) initiating anti-VEGF IVT from 1/1/2015-12/31/2019 using de-identified electronic medical records (IRIS® Registry). The change in visual acuity (VA) from baseline and anti-VEGF IVT frequency (average number of injections and intervals) were reported for up to 6 years of follow-up. VA outcomes were further stratified by baseline VA and number of injections (0, 1-2, 3-4, 5-7, 8-10, ≥11) for the given year.
Results :
At 1 year, 124,684 eyes received a mean (SD) of 3.9 (2.8) anti-VEGF injections with a mean injection interval of 10.0 (7.9) weeks and gained a mean of +3.2 (16.4) letters. Among patients with six years of follow up, at year 6, 1,235 eyes received a mean of 2.9 (2.1) injections with a mean interval of 12.3 (8.2) weeks and gained a mean of +0.5 (19.7) letters from baseline. Median follow-up time was 2.1 years. When stratified by baseline VA, overall change in VA was negative for eyes starting with VA ≥20/25 and <20/25 to 20/40, and positive for eyes starting with VA <20/40 to 20/80, <20/80 to >20/200, and ≤20/200 at the end of follow-up (Figure 1). When stratified by the average number of received injections in each year, change in VA from baseline was +2.8 in those who received 1-2 injections compared to +4.8 in those who received ≥11 injections in the first year. This trend was consistent in subsequent years (Figure 2).
Conclusions :
The number of injections decreased and injection intervals increased year over year up to 6 years regardless of baseline VA. Improvements in VA from baseline were greatest in eyes that received 5 or more injections each year. Results are unadjusted.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.