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Long‐term follow‐up of antivascular endothelial growth factor treatment for diabetic macular oedema: a four‐year real‐world study
Author(s) -
Granstam Elisabet,
Rosenblad Andreas,
Modher Raghib Aseel,
Granström Therese,
Eriksson Jan W.,
Lindholm Olinder Anna,
Leksell Janeth
Publication year - 2020
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14290
Subject(s) - medicine , ranibizumab , visual acuity , wilcoxon signed rank test , ophthalmology , diabetic retinopathy , quality of life (healthcare) , logistic regression , mann–whitney u test , exact test , aflibercept , bevacizumab , surgery , diabetes mellitus , nursing , chemotherapy , endocrinology
Purpose To evaluate visual acuity ( VA ) and central retinal thickness ( CRT ) on optical coherence tomography during a 4‐year period in patients treated for sight‐threatening diabetic macular oedema ( DMO ) at two Swedish county hospitals. Additionally, to compare health‐related quality of life and subjective visual functioning before and after 4 years of treatment. Methods Fifty‐eight patients with DMO were evaluated after 4 years of antivascular endothelial growth factor ( VEGF ) treatment. VA , CRT and clinical data were retrospectively reviewed. Health‐related quality of life and subjective visual functioning were evaluated with Short Form Health Survey ( SF ‐36) and National Eye Institute Vision Functioning Questionnaire 25 ( VFQ ‐25). Comparisons between independent groups were performed using Pearson's χ 2 test, Fisher's exact test or Mann–Whitney U test. Spearman's ρ was used for correlation analyses. Wilcoxon signed‐rank test was used for comparison between dependent groups. Logistic regression analysis was applied for analysis of VA and CRT over 4 years. Results Follow‐up data were obtained from 37 of 58 (63.8%) patients. Baseline characteristics were similar, regardless of follow‐up. VA improvement at 1 year (mean + 4.4, SD 7.5; ETDRS letter score) was maintained over 3 years, then declined. CRT was reduced throughout the study. In the first treatment year, eyes received 5.1 (1.4) anti‐ VEGF injections, followed by approximately two injections yearly. Additional treatment included laser and dexamethasone implants. SF ‐36 showed no change at 4 years, compared with baseline. VFQ ‐25 demonstrated improvement in near vision activities (p = 0.036). Conclusion Significant long‐term improvement in visual function was present in patients with anti‐ VEGF ‐treated DMO .