The following is a summary of “Predictive factors for treatment outcomes with intravitreal anti-vascular endothelial growth factor injections in diabetic macular edema in clinical practice,” published in the April 2023 issue of Opthalmology by Gurung et al.
Diabetic macular edema (DME) is a diabetic condition for which intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are considered the standard therapy.
In a multi-center retrospective observational study of 248 participants with DME, researchers used regression models to assess the association between demographic and clinical variables and best-corrected visual acuity (BCVA) and central macular thickness (CMT) outcomes after intravitreal anti-VEGF therapy.
They observed there was a significant improvement after 12 months in BCVA (P< 0.001) and CMT (P< 0.001). Although it was noteworthy that 21% of participants experienced a decrease in BCVA, and 41% had a CMT reduction of less than 10% at the 12-month mark.
Study suggested Baseline BCVA (p = 0.022, OR=-0.024, 95% CI=-0.046,-0.004) and longer duration of diabetic retinopathy (p = 0.048, OR=-0.064, 95% CI=-0.129,-0.001) were identified as negative predictors for BCVA response. In contrast, treatment with Aflibercept (p = 0.017, OR = 1.107, 95% CI = 0.220,2.051) compared to other drugs and a positive “early functional response” (P < 0.001, OR=-1.393, 95% CI=-1.946,-0.857) were identified as positive predictors. A higher baseline CMT (P< 0.001, OR = 0.019, 95% CI = 0.012,0.0261) and an “early anatomical response” (P < 0.001, OR=-1.677, 95% CI=-2.456, -0.943) were identified as predictors for a more significant reduction in CMT. Broadly, these variables could only predict 23% of the BCVA response and 52% of the CMT response. This study highlighted clinical factors predicting anti-VEGF response in DME patients.