Journal Article Multicenter Study Research Support, Non-U.S. Gov't Ppublish 1 citation
PubMed: 39423137 DOI: 10.1097/IAE.0000000000004301
ALTERATION OF TREATMENT CHOICES AND THE VISUAL PROGNOSIS FOR DIABETIC MACULAR EDEMA IN THE ERA OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR DRUGS: Analysis of the STREAT-DME 2 Study.
Retina 45(2):335-344
Authors: Masahiko Shimura, Takao Hirano, Eiko Tsuiki, Yoshihiro Takamura, Yuki Morizane, Kunihiko Akiyama, Kaori Yamamoto, Taiichi Hikichi, Takashi Koto, Takamasa Kinoshita, Sentaro Kusuhara, Shigeo Yoshida, Shin-Ichi Sakamoto, Kazuhiro Kimura, Masahiko Sugimoto, Teruyo Kida, Yoshinori Mitamura, Yoko Takatsuna, Noriaki Washio, Rie Osaka, Tetsuki Ueda, Akira Minamoto, Jiro Kogo, Fumiki Okamoto, Hiroshi Enaida, Yoshihito Sakanishi, Taiji Nagaoka, Fumi Gomi, Mariko Sasaki, Hiroto Terasaki, Takeshi Iwase, Tomoaki Tatsumi, Kosuke Nishi, Kei Shinoda, Shunichiro Ueda, Tomoko Ueda-Consolvo, Hiroyuki Nakashizuka, Toshinori Murata, Shigehiko Kitano, Taiji Sakamoto
Affiliations
- Department of Ophthalmology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
- Department of Ophthalmology, Shinshu University School of Medicine, Nagano, Japan.
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
- Department of Ophthalmology, University of Fukui, Fukui, Japan.
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
- Department of Ophthalmology, NHO Tokyo Medical Center, Tokyo, Japan.
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.
- Hikichi Eye Clinic, Hokkaido, Japan.
- Kyorin Eye Center, Kyorin University, School of Medicine, Tokyo, Japan.
- Department of Ophthalmology, Sapporo City General Hospital, Hokkaido, Japan.
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
- Department of Ophthalmology, Kurume University School of Medicine, Fukuoka, Japan.
- Department of Ophthalmology, Jichi Medical University, Tochigi, Japan.
- Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
- Department of Ophthalmology, Mie University Graduate School of Medicine, Mie, Japan.
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
- Department of Ophthalmology, Chiba Rosai Hospital, Chiba, Japan.
- Department of Ophthalmology, Showa General Hospital, Tokyo, Japan.
- Department of Ophthalmology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
- Department of Ophthalmology, Nara Medical University, Nara, Japan.
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
- Department of Ophthalmology, St. Marianna University School of Medicine, Kanagawa, Japan.
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
- Department of Ophthalmology, Faculty of Medicine, Saga University, Saga, Japan.
- Department of Ophthalmology, Juntendo University Urayasu Hospital, Chiba, Japan.
- Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Tokyo, Japan.
- Department of Ophthalmology, Hyogo Medical University, Hyogo, Japan.
- Department of Ophthalmology, Tachikawa Hospital, Tokyo, Japan.
- Keio University School of Medicine, Tokyo, Japan.
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
- Department of Ophthalmology, Akita University Faculty of Medicine, Akita, Japan.
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan.
- Department of Ophthalmology, Wakayama Medical University, Wakayama, Japan.
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan.
- Department of Ophthalmology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.
- Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
- Department of Ophthalmology, Nihon University Hospital, Tokyo, Japan ; and.
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan .
Abstract
PURPOSE
To assess the real-world outcome of best-corrected visual acuity after 2-year intervention for treatment-naive diabetic macular edema since the approval of anti-vascular endothelial growth factor therapy.
METHODS
A total of 1,780 treatment-naive eyes with diabetic macular edema for which intervention was initiated between 2015 and 2019, and which were followed for 2 years, were extracted from the longitudinal medical records of 37 retinal disease institutions in Japan. Interventions included anti-VEGF therapy, topical corticosteroid therapy, macular photocoagulation, and vitrectomy. The baseline and final best-corrected visual acuity, and the number and timing of interventions were recorded. Eyes were classified according to the year in which intervention was initiated.
RESULTS
Over a 2-year period, best-corrected visual acuity improved annually, finally reaching seven letters. The proportion of eyes in which good vision was maintained (best-corrected visual acuity >20/40) increased to 73.3% in the latest period. The administration of anti-VEGF therapy remained stable, accounting for approximately 90% of eyes. Notably, the proportion of eyes receiving anti-VEGF drugs as first-line treatment increased dramatically to approximately 80%.
CONCLUSION
Anti-VEGF therapy has become the first-line treatment since the approval of anti-VEGF drugs for diabetic macular edema. These findings reflect the evolution of diabetic macular edema treatment and highlight the superiority of anti-VEGF therapy and its increased uptake over time.
MeSH
Eye, Vascular Endothelial Growth Factor A, Pharmaceutical Preparations, Macular Edema, Therapeutics, Retinal Diseases, Vitreous Body, Edema, Prognosis