Anti-vascular endothelial growth factor therapy in diabetic macular edema: real-life outcomes from a multicenter study in Turkey over 36 months.

Autor: Durukan AH; Department of Ophthalmology, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey. drahdurukan@yahoo.com., Unlu N; Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey., Onen M; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Alp MN; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Yeşiltaş YS; Department of Ophthalmology, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey., Kalayci D; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Acar MA; Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey., Sekeroglu MA; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Citirik M; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Altintas AGK; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Hazirolan D; Department of Ophthalmology, Ankara Training and Research Hospital, Ankara, Turkey., Kucukevcilioglu M; Department of Ophthalmology, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey., Ozdal PC; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Toklu Y; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Bicer T; Department of Ophthalmology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey., Ugurlu N; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Budakoglu O; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Yazar Z; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Ucgun NI; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Serdar K; Augenland MVZ Goethaplatz, Frankfurt, Germany., Doguizi S; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Erol YO; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Atilgan CU; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Yorgun MA; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Soba DO; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Berker N; Department of Ophthalmology, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey., Baskan C; Department of Ophthalmology, Ankara City Hospital, Ankara, Turkey., Yilmaz ES; Biostatistics, Novo Nordisk LTD, Ankara, Turkey.
Jazyk: angličtina
Zdroj: International ophthalmology [Int Ophthalmol] 2022 Dec; Vol. 42 (12), pp. 3777-3787. Date of Electronic Publication: 2022 Jul 13.
DOI: 10.1007/s10792-022-02375-6
Abstrakt: Purpose: This study aimed to report the visual and anatomical outcomes of intravitreal anti-VEGF treatment for diabetic macular edema (DME) in a real-world clinical setting from Turkey over 36 months.
Methods: This is a retrospective, multicenter (7 sites) study. The medical records of 1072 eyes (both previously treated and naive eyes) of 706 consecutive patients with visual impairment due to center-involving DME treated with intravitreal anti-VEGF injections between April 2007 and February 2017 were reviewed. The eyes were divided into mutually exclusive three groups based on the duration of follow-up (12, 24, or 36 months). Primary outcome measures were changes in visual acuity (VA) and central macular thickness (CMT) from baseline to final visit in each cohort, frequency of visits and intravitreal anti-VEGF injections. As secondary endpoints, VA outcomes were assessed in subgroups stratified by baseline VA [<70 ETDRS letters and ≥70 ETDRS letters] and loading dose status of anti-VEGF injections.
Results: VA increased by a mean of 8.2 letters (12-month cohort, p < 0.001), 5.3 letters (24-month cohort, p < 0.001), and 4.4 letters (36-month cohort, p = 0.017) at final visits. The eyes with <70 VA letters achieved more significant VA improvement at final visits in all cohorts compared with eyes with >70 VA letters (p < 0.001). The mean decreases in CMT from baseline to last visits at 12-, 24-, and 36- month cohorts were -100.5 µm, -107.7 µm, and -114.3 µm, respectively (p < 0.001). The mean number of injections given were 4.6, 2.3, and 1.8 during years 1 to 3, respectively. Patients who received loading dose showed greater VA gains than those who did not in all follow-up cohorts.
Conclusion: Our study revealed that anti-VEGF treatment improved VA and CMT over a follow-up of 36 months. Although these real-life VA outcomes following anti-VEGF therapy for DME were similar to other real-life studies, they were inferior to those noted in randomized controlled trials, mainly due to undertreatment.
(© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
Externí odkaz: