![]() The management and visual outcome in older patients with DME would be unsatisfactory in real-world clinical practice. Treatments applied in the 2-year period exhibited decreasing trends with increasing age category on the number of intravitreal injections of anti-VEGF agents (P = 0.06), selecting local corticosteroid injection (P = 0.031), vitrectomy (P < 0.001), and laser photocoagulation outside the great vascular arcade (P < 0.001).Ĭompared with younger patients with DME, patients with DME aged ≥75 years showed less frequent treatment, lower BCVA gain, and smaller CRT decrease. The outcomes were change in logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA) and central retinal thickness (CRT) and number of treatments from baseline to 2 years.įrom baseline to 2 years, the mean changes in logMAR BCVA from baseline to 2 years were -0.01 in C1, -0.06 in C2, -0.07 in C3, and 0.01 in C4 (P = 0.016), and the mean changes in CRT were -136.2 μm in C1, -108.8 μm in C2, -100.6 μm in C3, and -89.5 μm in C4 (P = 0.008). Patients were categorized by age at baseline (C1, <55 C2, 55-64 C3, 65-74 and C4, ≥75 years). This is a real-world clinical study including 1552 patients with treatment-naïve center-involved DME. This study aims to evaluate the effects of aging on the management of DME. In older patients, the management of diabetic macular edema (DME) would be complicated by comorbidities, geriatric syndrome, and socioeconomic status. Safety in these studies was consistent with the known safety profile of IAI.Ĭopyright © 2015 American Academy of Ophthalmology. In both VISTA and VIVID, the 52-week visual and anatomic superiority of IAI over laser control was sustained through week 100, with similar efficacy in the 2q4 and 2q8 groups. In an integrated safety analysis, the most frequent serious ocular adverse event was cataract (2.4%, 1.0%, and 0.3% for 2q4, 2q8, and control). Significantly more eyes in the IAI 2q4 and 2q8 groups versus those in the laser control group had a ≥2 step improvement in the DRSS score in both VISTA (37.0% and 37.1% vs. Mean BCVA gain from baseline to week 100 with IAI 2q4, IAI 2q8, and laser control was 11.5, 11.1, and 0.9 letters (P < 0.0001) in VISTA and 11.4, 9.4, and 0.7 letters (P < 0.0001) in VIVID, respectively. This report presents the 100-week results including mean change from baseline in BCVA, proportion of eyes that gained ≥15 letters, and proportion of eyes with a ≥2-step improvement in the Diabetic Retinopathy Severity Scale (DRSS) score. The primary end point was mean change from baseline in best-corrected visual acuity (BCVA) at week 52. Patients (eyes n=872) with type 1 or 2 diabetes mellitus who had DME with central involvement.Įyes received IAI 2 mg every 4 weeks (2q4), IAI 2 mg every 8 weeks after 5 monthly doses (2q8), or laser control. Two similarly designed, randomized, phase 3 trials, VISTA(DME) and VIVID(DME). To compare efficacy and safety of 2 dosing regimens of intravitreal aflibercept injection (IAI) with macular laser photocoagulation for diabetic macular edema (DME). ![]()
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