Real-life anti-vascular endothelial growth factor treatment for age-related macular degeneration and diabetic macular edema in an Italian tertiary referral hospital

Eur J Ophthalmol. 2020 Nov;30(6):1461-1466. doi: 10.1177/1120672119880386. Epub 2019 Oct 16.

Abstract

Purpose: To study the real-life outcomes of intravitreal anti-vascular endothelial growth factor treatment in patients affected by age-related macular degeneration and diabetic macular edema in an Italian tertiary referral hospital over a 2-year follow-up.

Methods: Patients with confirmed diagnosis of age-related macular degeneration or diabetic macular edema and 2 years of follow-up were retrospectively analyzed. They underwent a loading dose of three monthly anti-vascular endothelial growth factor injections, with re-treatment performed following a "pro-re-nata" regimen. Best-corrected visual acuity and central retinal thickness were collected and statistically analyzed.

Results: In total, 167 diabetic macular edema eyes and 108 age-related macular degeneration eyes were included. Mean age was 63.4 ± 11.8 years for diabetic macular edema and 75.6 ± 8.4 years for age-related macular degeneration. For diabetic macular edema patients, mean number of injections was 5.0 ± 1.7 at 1 year and 2.8 ± 1.8 at 2 years. Mean best-corrected visual acuity improved from 60 Early Treatment for Diabetic Retinopathy Study letters to 66.7 letters at 1 year, and to 70 letters at 2 years (p < 0.001). Mean central retinal thickness decreased from 459 ± 148 µm to 327 ± 163 µm and 261 ± 89 µm, respectively, at the first and the second year (p < 0.001).With respect to age-related macular degeneration patients, mean number of injections was 5.3 ± 2.2 at 1 year and 3.3 ± 1.5 at 2 years. Mean best-corrected visual acuity improved from 63 Early Treatment for Diabetic Retinopathy Study letters to 68 letters at 1 year and to 70 letters at 2 years (p < 0.001). Mean central retinal thickness was 411 ± 146 µm, decreasing to 271 ± 93 µm at 1 year and 260 ± 68 µm at 2 years (p < 0.001).

Conclusions: Our study described the 2-year real-life outcome of anti-vascular endothelial growth factor treatment of diabetic macular edema and age-related macular degeneration.

Keywords: Age-related macular degeneration; diabetic macular edema; diabetic retinopathy; retina; retina—medical therapies.

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / drug therapy*
  • Female
  • Humans
  • Intravitreal Injections
  • Italy
  • Macular Degeneration / diagnosis
  • Macular Degeneration / drug therapy*
  • Macular Edema / diagnosis
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Male
  • Middle Aged
  • Ranibizumab / administration & dosage*
  • Retrospective Studies
  • Tertiary Care Centers*
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity*

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Ranibizumab