Anti-vegf therapy in diabetic macular oedema patients over four years

OBJECTIVES: To evaluate visual acuity (VA) outcomes of intravitreal anti-vascular endothelial growth factor (VEGF) in diabetic macular oedema (DMO). METHODS: In this retrospective cohort study, electronic medical records for all patients undergoing intravitreal injections (IVI) in a tertiary referral centre between March 2013 and October 2018 were analysed. Treatment response in terms of visual acuity outcomes were reported for all eyes over a 4-year observation period. RESULTS: Our cohort includes 2614 DMO eyes of 1964 patients over 48 months. Cox proportional hazards modelling identified injection number (hazard ratio [HR] = 1.18), male gender (HR = 1.13), and baseline VA (HR = 1.09) as independent predictors to reach a favourable visual outcome of more than 70 Early Treatment Diabetic Retinopathy Study (ETDRS) letters. Half of our cohort reached 70 letters 1.9 months after starting anti-VEGF therapy. Of those that reached 70 letters, 50% fell below 70 by 14.7 months. CONCLUS...研究目的：评估玻璃体腔注射抗血管内皮生长因子（anti-vascular endothelial growth factor, VEGF）治疗糖尿病性黄斑水肿（diabetic macular oedema, DMO）的视力（visual acuity, VA）转归情况。 研究方法：本研究为回顾性队列研究，分析了2013年3月至2018年10月间，某三级转诊中心内所有接受玻璃体腔注射术（intravitreal injections, IVI）的患者的电子病历资料，并报告了4年随访观察期内所有患眼的视力转归相关治疗应答情况。 研究结果：本队列共纳入1964例患者的2614只糖尿病性黄斑水肿患眼，随访时长为48个月。通过Cox比例风险模型（Cox proportional hazards modelling）分析发现，注射次数（风险比[HR]=1.18）、男性性别（HR=1.13）以及基线视力（HR=1.09）是达到70个以上早期糖尿病视网膜病变治疗研究（Early Treatment Diabetic Retinopathy Study, ETDRS）字母数这一良好视力转归的独立预测因素。本队列中有50%的患者在开始抗VEGF治疗后1.9个月即可达到70个ETDRS字母数；而在达到该视力水平的患者中，有50%会在14.7个月后视力回落至70个ETDRS字母数以下。