Retinal vasculitis with or without retinal vascular occlusion among eyes with nAMD or DME treated with IVT agents as recorded in the Vestrum database

Abstract

Purpose : To assess incidence of retinal vasculitis (RV) with or without retinal vascular occlusion (RO) among eyes with neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME) treated with intravitreal (IVT) agents as recorded by individual clinicians in routine clinical practice in the US.

Methods : This was a retrospective observational study of eyes in patients (≥ 18 years) with nAMD or DME, that received ≥ 1 IVT treatment from 01/01/2014–31/03/2023 following initial diagnosis, from the Vestrum database. Eyes with no visits following the index injection; or eyes that had diagnoses of IOI, RV, or RO on or prior to index injection were excluded. Incidence of the first event of RV, RV and RO, and intraocular inflammation (IOI; including RV) and RO, recorded as occurring within 180 days of an IVT injection were identified using ICD-9/10-CM diagnosis codes through the end of the study period (30/09/2023). Eyes were not followed for additional events after the first instance. Event incidence by approved IVT agents for nAMD or DME of interest, including faricimab (FAR), aflibercept (AFL), ranibizumab (RAN), and brolucizumab (BRO) were recorded. Events were attributed to the IVT agent immediately prior to (but not on) the date of the event.

Results : 302,334 eyes, receiving over 4 million injections, were included in the analysis. The incidence of RV, RV with RO, and IOIs with RO were low across IVT agents. The percentage (%, 95% CI) of exposed eyes with recorded IOI (including RV) with RO events were broadly comparable between FAR (0.013; 0.004–0.037), AFL (0.025; 0.019–0.033), and RAN (0.011; 0.007–0.018), but was higher for BRO (0.148; 0.072–0.306). Similarly, for RV, and RV with RO, event incidence (%) among exposed eyes were low and generally comparable between FAR (0.008/0), AFL (0.005/0.001), and RAN (0.002/0.001). However, the percentages of eyes with RV, and RV with RO, events were highest for BRO (0.339/0.064), respectively (Table).

Conclusions : Incidence of first RV, RV and RO, and IOI and RO events are similar among eyes treated with FAR, AFL, and RAN. Eyes treated with BRO had a higher incidence than other approved IVT agents.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Table: Overview of events by IVT agent