医学
自然科学
视力
加药
养生
眼科
血管抑制剂
糖尿病性黄斑水肿
外科
糖尿病性视网膜病变
内科学
糖尿病
贝伐单抗
化疗
内分泌学
作者
Gurkaran S. Sarohia,Keean Nanji,Mohammad Daud Khan,Faran Khalid,D Rosenberg,Deven Deonarain,Mark Phillips,Lehana Thabane,Peter K. Kaiser,Sunir J. Garg,Sobha Sivaprasad,Charles C. Wykoff,Varun Chaudhary
标识
DOI:10.1016/j.survophthal.2022.04.003
摘要
Anti-vascular endothelial growth factor (Anti-VEGF) agents are the standard of care for diabetic macular edema (CI-DME) with vision loss. They are commonly administered using several treatment protocols, including fixed, pro re nata (PRN) and treat-and-extend (T&E) regimens. Because of the lack of evidence defining an ideal treatment paradigm, we systematically compared T&E with fixed or PRN regimens. Visual acuity improvement was similar when comparing T&E to fixed or PRN dosing at 12 and 24 months. Regarding anatomic outcomes, no significant difference was found between T&E and fixed regimens for central retinal thickness or central subfoveal thickness at 12 and 24 months. Similarly, no significant difference was found for central retinal thickness at 12 months for T&E versus PRN regimen. Regarding total number of injections, no significant difference existed between T&E versus fixed regimens at 12 months. PRN regimens delivered fewer injections compared to T&E regimens at 12 months. The results of this analysis support that visual acuity and anatomic outcomes at 12 and 24 months are similar between T&E with either fixed or PRN regimens. More head-to-head trials comparing T&E versus fixed and PRN dosing are needed to provide visual and functional outcome data beyond year 2. PROSPERO Registration: CRD42021249362.
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