OPTIMIZING TREATMENT PROTOCOLS FOR DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY OF SINGLE VS. MULTIPLE INTRAVITREAL ANTI-VEGF INJECTIONS

Abstract

Objective:
The aim of the research study is to evaluate single versus multiple intravitreal anti-VEGF injections in patients with diabetic macular edema (DME) with respect to the effect of different number of injections on the visual acuity, macular thickness and patient’s outcome at 12 months of follow up.

Study Design: It is a longitudinal experiment and it was carried out in tertiary care ophthalmology center.

Methods: Sixty patients with DME were randomly allocated into two groups whereby one study group would receive a single intravitreal injection of anti-VEGF therapy and whereas, in the other group of patient’s multiple intravitreal injections (namely three) of anti-VEGF would be administered over the period over which the study lasted. Primary outcome measure was the change in the best-corrected visual acuity (BCVA), and second results was macular thickness using optical coherence tomography (OCT).

Results:

The patients who were administered with the multiple injections exhibited a higher improvement in BCVA (average of 8 letters) as compared to those who were administered with a single injection (average of 4 letter) (p<0.05). There was also an enhanced reduction in macular thickness in the multiple injection group (a mean decrease of 150 microns) with a lesser decrease in the single injection group (a mean decrease of 80 microns).

Conclusion:

More injections of anti-VEGF intravitreal agent provide better outcomes in managing DME compared with one intravitreal injection and result in better visual acuity and macular thickness. This finding implies that anti-VEGF drugs applied more often might show improved clinical result of DME patients.

Keywords:
Diabetic macular edema, anti-VEGF, intravitreal injections, treatment protocol, visual acuity, macular thickness, longitudinal study