Efficacy evaluation of anti-vascular endothelial growth factor drugs in the treatment of different types of diabetic macular edema
10.13389/j.cnki.rao.2024.0123
- VernacularTitle:抗VEGF药物治疗不同类型糖尿病黄斑水肿的疗效评估
- Author:
Ni HE
1
;
Juan SHI
;
Jun LI
Author Information
1. 416000 湖南省湘西土家族苗族自治州,湘西自治州人民医院(吉首大学第一附属医院)眼科
- Keywords:
diabetic retinopathy;
macular edema;
vascular growth inhibitor;
optical coherence tomography
- From:
Recent Advances in Ophthalmology
2024;44(8):643-648
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the differences in the efficacy of different anti-vascular endothelial growth factor(VEGF)drugs in treating different types of diabetic macular edema(DME)and clarify which anti-VEGF drug is the most effective.Methods A retrospective cohort study was conducted on 149 patients(205 eyes)diagnosed with DME in the Ophthalmology Department of Lishui Municipal Central Hospital from October 2018 to November 2021 and diagnosed with DME in the Ophthalmology Department of Xiangxi Autonomous Prefecture People's Hospital from January 2022 to July 2023.General data of the patients were collected.The best-corrected visual acuity(BCVA)and the central foveal thickness(CFT)were measured.According to the morphological characteristics shown by optical coherence tomography(OCT),DME was classified into the cystoid macular edema(CME)type[CME group(57 eyes)],diffuse retinal thickening(DRT)type[DRT group(78 eyes)],serous retinal detachment(SRD)type[SRD group(31 eyes)],and mixed type[mixed group(39 eyes)].Patients were treated with the intravitreal injection of aflibercept(IVA)[IVA group(55 eyes)],con-bercept(IVC)[IVC group(64 eyes)],ranibizumab(IVR)[IVR group(80 eyes)],and ranibizumab and aflibercept(IVR+IVA)[IVR+IVA group(6 eyes)],as per the 1+PRN regimen(once a month and as needed thereafter).The differences in BCVA and CFT before and after treatment with different drugs for different OCT types of eyes were compared and analyzed.Results There was no significant difference in the general data of patients among the CME group,DRT group,SRD group,and mixed group,except body mass index(BMI)(all P＞0.05),and the BMI of patients in the SRD group was the lowest.Before treatment,the 4 groups showed significant differences in BCVA(logMAR)and CFT(all P＜0.05).The baseline visual acuity of patients in the DRT group was the best,while the baseline CFT was the lowest.There was a significant difference in BCVA(logMAR)before treatment,1 day and 1 month after treatment in the IVA,IVC and IVR groups(F=34.553,P＜0.001),while there was no significant difference in BCVA(logMAR)among different drug types(F=1.312,P=0.272).The differences in BCVA(logMAR)before treatment,1 day after treatment,and 1 month after treatment were statistically significant in the CME,DRT and SRD groups(F=32.564,P＜0.001)and among different OCT types(F=5.227,P=0.002);after treatment,the visual acuity of patients in the DRT group was the best,and the visual acuity of patients in the SRD group was the poorest.The CFT reduction(difference between before treatment and 1 month after treatment)showed a significant difference in the CME,DRT,SRD and mixed groups(x2=58.279,P＜0.001)but no significant difference in the IVA,IVR and IVC groups(F=0.978,P=0.378).In the mixed group,the difference in BCVA(logMAR)between the IVA subgroup and the IVR subgroup before treatment,1 day after treatment,and 1 month after treatment was statistically significant(P=0.023),and the visual acuity of patients in the IVA subgroup was better than that of patients in the IVR subgroup.Conclusion Anti-VEGF drugs can effectively reduce CFT and increase BCVA in DME eyes with different OCT types.However,the efficacy is mainly related to the OCT types,with the best response in the DRT group and the worst visual acuity in the SRD group.The difference in effectiveness between drugs is not significant,and only IVA is found to be superior to IVR in the mixed group.
