Ten-Year -Real World Outcome (RWO) of Anti Vascular Endothelial Growth Factor Therapy(Anti VEGF)in Diabetic MAcular Oedema(DMO).

Abstract

Purpose : The Aim of the study was to examine the RWO of treating DMO with Anti VEGF in a series of patients who had follow up for 10 years.

Methods : A single centre retrospective review of electronic patient records was done for those diagnosed with DMO with Central Macular Thickness(CMT)of >400microns and initiated on anti-VEGF injections at Frimley Park Hospital ,UK and followed up for 10 years starting from1st January 2011.
The patients were initiated with IVI either Bevacizumab(1.25mg) Ranibizumab(0.5mg) or Aflibercept (2mg) based on NICE criteria .Five monthly injectionswere given and then reviewed and treated as per clinician's discretion.
At each visit best Corrected Viaual Acuity(BCVA)using Early Treatment Diabetic Retinopathy Study (ETDRS)letters, slit lamp Biomicroscopy and Optical Coherence tomography(OCT) were performed.

Baseline BCVA and CMTwere compared with the data after loading injections first third five seven and ten yearsThe number of IVI at the end of one year was also analysed and compared to the RCT.

The primary end point was change in VA and CMT at one three five seven and ten years.
The secondary end point was to compare the RWO with the RCT such as RESTORE PROTOCOL I and PROTOCOL. T

Results : 459 eyes of patients diagnosed with Diabetic Macular Oedema were analysed over a period of ten years,of which 170,155 and 134 eyes received Ranibizumab,Aflibercept and Bevacizumab respectively.Sixty-nine of the eyes completed ten -year follow up.During the treatment course 62 eyes were switched to either Ranibizumab or Aflbercept from Bevacizumab.

The average number of injections were 6.12 after one year of start of treatment.VA improved at 3 years by 4.79 letters and CMT reduced by 77.53.At 5 and 10 years the CMT reduced by 65.47 and 68.20 and visual acuity by 3.02 and 1.61 letters from Baseline respectively.

Conclusions : Results show that the RWD is comparable to RCT at 3 years ,however VA started declining after 5 years which continued gradually as shown by the ten-year data despite stable reduction in CMT.

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