Early Response to Anti-Vascular Endothelial Growth Factor and Two-Year Outcomes Among Eyes With Diabetic Macular Edema in Protocol T
Bressler NM, Beaulieu WT, Maguire MG, et al; Diabetic Retinopathy Clinical Research Network Am J Ophthalmol. 2018;195:93-100
Study Summary
Previous studies have shown that eyes with diabetic macular edema (DME) with extensive early improvements in visual acuity (VA) after anti-vascular endothelial growth factor (VEGF) therapy have better long-term visual quality.
The Diabetic Retinopathy Clinical Research Network conducted a post-hoc analysis of the data from Protocol T to study the association between VA at 12 weeks after anti-VEGF treatment for DME, optical coherence tomography central subfield thickness (CST), and 2-year follow-up VA.
There were 616 patients who met inclusion criteria for having central-involved DME with a best corrected VA score of 78 through 24 (approximate Snellen equivalent 20/32 to 20/320) and a CST of at least 250 µm. Patients were randomly assigned to receive one of the three anti-VEGF injections (bevacizumab, ranibizumabor aflibercept) at baseline and every 4 weeks for the first 20 weeks. However, injection was deferred if the VA letter score was 84 or better (Snellen equivalent 20/20) after two consecutive injections, or the CST was less than sex- and instrument-specific cutoffs (Heidelberg Spectralis ≥ 320 µm for men and ≥ 305 µm for women, Zeiss Cirrus ≥ 305 µm for men and ≥ 290 µm for women, Zeiss Stratus ≥ 250 µm for both sexes).
