Anti-VEGFs Improve Vision and Structure in Diabetic Macular Edema

Anti-vascular endothelial growth factor (anti-VEGF) therapies effectively reduce retinal thickness and improve best-corrected visual acuity (BCVA) in patients with diabetic macular edema (DME), according to the results of a study published in Clinical Ophthalmology.

Researchers conducted a study to evaluate the visual outcomes and safety profile of anti-VEGF therapy in the treatment of DME in real-world studies in Asian countries through the systematic review of electronic literature databases. The review identified observational studies that reported clinical and safety outcomes of anti-VEGF treatments for DME in Asia. Patient characteristics, treatment patterns, mean number of injections, best-corrected visual acuity (BCVA), retinal thickness, and safety outcomes were analyzed.

Of 71 included studies, most (n=33) reported treatment of DME with ranibizumab, followed by aflibercept (n=13), bevacizumab (n=28), and conbercept (n=9). The cumulative mean number of injections at 12 months was 5.2 for ranibizumab, 4.6 for aflibercept, and 6 for conbercept. Cumulative mean BCVA gain was 6.8 letters (ranibizumab), 4.6 letters (aflibercept), 4.9 letters (bevacizumab), and 8.3 letters (conbercept) at the 12-month follow-up. 

At 12 months, the cumulative mean reduction in retinal thickness was 116.9 μm (ranibizumab), 105.9 μm (aflibercept), 81.7 μm (bevacizumab), and 135.2 μm (conbercept). 

Researchers note a strong positive correlation (r=0.78) between mean number of injections and change in BCVA at 12 months; a moderate positive correlation (r = 0.54) between mean number of injections and mean reduction in retinal thickness at 12 months; and a weak positive correlation between baseline retinal thickness and visual acuity at 12 months. Predictors of BCVA at 12 months included baseline BCVA and mean number of injections. 

“The data suggest that a greater number of anti-VEGF injections was associated with better improvement in BCVA and moderate reduction in retinal thickness at the 1-year follow-up,” the researchers explain.

The study emphasizes that, due to limitations including a heterogenous study population, treatment posology, and frequency of injections, no conclusion could be drawn regarding the comparative efficacy of anti-VEGFs. 

Disclosure: Multiple study authors declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.