Abstract
Purpose :
Globally, 21 million people are suffering from diabetic macular oedema (DMO), which is the leading cause of blindness in the working-age population. Long-term outcomes in real-life settings are required to understand the importance of regular monitoring and treatment. This is a retrospective, real-life cohort study in which we investigated the functional and anatomical outcomes of patients treated with intravitreal aflibercept injections over five years.
Methods :
Thirty-one anti-VEGF naïve eyes with diabetic macular oedema receiving intravitreal anti-VEGF therapy were included in this 5-year statistical analysis. Each patient had corrected visual acuity (VA) in ETDRS letters and OCT central foveal thickness (CFT) performed at baseline, 1, 2,3,4, and 5 years. The analysis entered those patients who completed the 5-year follow-up and whose treatment was not interrupted by the current pandemic covid19. Patients were initiated on a loading phase of five one-monthly intravitreal aflibercept injections, followed by injections if needed as per clinicians’ discretion. Subgroup analysis was done according to baseline VA for those eyes with ≥ 69 ETDRS letters and those with < 69 ETDRS letters at baseline.
Results :
The mean number of aflibercept injections received by the end of the 5-year follow-up was 20.46 intravitreal injections. Ten percent of eyes required only a 5-monthly loading dose with no further injections by the end of the follow-up.
At baseline, the mean VA (SD) was 65.57 (11.64) ETDRS letters, whilst the mean CFT (SD) was 421 (130) µm. At five years, the mean VA (SD) was 70.50 (11.81) ETDRS letters (p = .0139) At the end of the follow-up, the mean CFT (SD) was 328 (116) μm (p = .0069) Six (19%) eyes gained ≥ 15 ETDRS letters, whilst ten (32 %) eyes gained ≥ 10 ETDRS letters at the end of year 5. Fifty percent of eyes had baseline VA ≥ 69 ETDRS letters, and that subgroup achieved main +0.85 ETDRS letters gain in the vision over five years of follow-up. The rest of the eyes had VA worse than 69 ETDRS letters at baseline, and this subgroup achieved a gain of +8.5 ETDRS letters at the end of the follow-up.
Conclusions :
The visual acuity and central foveal thickness have significantly improved since baseline over five years of treatment. Regular monitoring and treatment of patients are important to maintain improved vision over a long time period.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.