First Author: A.Al-Mousawi UK
Co Author(s): F. Hussain M. Subash R. Sandhu V. Sundaram
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Diabetic retinopathy is one of the leading causes of blindness in the UK, with diabetic macular oedema (DMO) contributing significantly to this burden of disease. The advent of intravitreal anti-VEGF therapy as gold-standard treatment for DMO has been shown to significantly improve visual outcomes compared with traditional focal laser. The primary aim was to compare 6-month visual and anatomical outcomes of patients receiving intravitreal Aflibercept (IVT-A) for DMO with those reported in the monthly-dosing arm of the VIVID trial.
Ophthalmology Out-patient Department, Luton and Dunstable University Hospital, Luton, UK
Retrospective case notes review was undertaken of 40 eyes treated with IVT-A for DMO between November 2015 and April 2016 at our unit. Baseline best corrected visual acuity (BCVA) in Early Treatment Diabetic Retinopathy Study (ETDRS) letters and central retinal thickness (CRT) on optical coherence tomography were compared with those at 6 months. Mean changes in BCVA and CRT were compared to those reported by the VIVID trial.
Mean BCVA gain at 6 months was 7.2 letters versus 10.5 letters in VIVID at 12 months, with a mean reduction in CRT of 66µm versus 195µm. 30% of eyes gained ≥10 letters from baseline and 18% gained ≥15 letters versus 54.4% and 32.4% respectively in the VIVID trial.
Local visual and anatomical outcomes were comparable to published data. The modest effect sizes observed can be attributed to the smaller size of our cohort, comparing 6-month with 12-month outcomes of treatment-experienced versus treatment-naïve patients, and the expected difference between efficacy and real-world data. Further audit at 12 months will allow for a more direct comparison.