Abstract
Purpose :
To investigate the yearly change of real-world outcomes for best corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve diabetic macular edema (DME) in the era of approval of anti- vascular endothelial growth factor (VEGF) therapy.
Methods :
Retrospective analysis of aggregated, longitudinal medical records obtained from 36 retina specialized institutions in Japan from Survey of Treatment for DME 2 database. A total of 1617 treatment-naïve center involving DME eyes of which the initial intervention started between 2015 and 2019, and had been followed for 2 years, were eligible. As interventions, anti-VEGF agents, local corticosteroids, macular photocoagulation and vitrectomy were defined. In each eye, baseline and final BCVA, the number of each intervention for 2 years was extracted. Each eye was classified by starting year of interventional treatment.
Results :
Although baseline BCVA did not change by year, 2-year improvement of BCVA had been increased, and reached to +8.5 letters in the latest term. There is little difference among starting year about proportions of eyes which BCVA gained >15 letters, in contrast to those which lost >15 letters were decreased by year. The proportion of eyes receiving anti-VEGF therapy was dramatically increased from 77.0% and reached to 90.7% in the latest term, while its injection frequency of about 6 times per 2 year did not changed by year. The proportion of eyes which maintained socially good vision of BCVA>20/40 has been increased from 49.0%, and reached to 72.0% in the latest.
Conclusions :
After the approval of anti-VEGF therapy in Japan (1994), anti-VEGF therapy has become the first-line therapy treatment patterns for DME and 90% of DME eyes were applied in recent real world clinical practice in Japan; as a result, better visual gain, suppression of worsened eyes and better final BCVA have been obtained, while injection frequency of anti-VEGF agents has been still lower than those in clinical trials.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.