Real-World Evidence of Diabetic Macular Edema Treated by Micro-Pulse Laser Therapy Combined with Anti-VEGF

Navigated laser therapy introduces computerized assistance systems to retinal laser photocoagulation treatment. The Navilas system offers high precision and safety and provides additional advantages regarding standardization of planning, execution, documentation, quality assurance, and better overall treatment comfort for the patient as main benefits over conventional laser. Navigated laser therapy is being used with good success in the treatment of diabetic macular edema (DME), retinal vein occlusions (RVO), and fast-pattern navigated panretinal photocoagulation in proliferative diabetic retinopathy (PDR). In center-involving DME, a combination of anti-vascular endothelial growth factor (VEGF) and macular laser may provide advantages over anti- VEGF monotherapy. In terms of navigated laser therapy, recent study data from our clinic and other institutions indicate that combined initial anti-VEGF and navigated macular laser therapy allows treatment success to be achieved and maintained with a significantly reduced number of interventions.

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Role of focal laser retinal photocoagulation in treatment of diabetic macular edema

Perm Medical Journal ◽

10.17816/pmj38256-69 ◽

2021 ◽

Vol 38 (2) ◽

pp. 56-69

Author(s):

I. V. Ionkina ◽

A. G. Grinev ◽

O. M. Zherebtsova

Keyword(s):

Macular Edema ◽

Laser Therapy ◽

Diabetic Macular Edema ◽

Laser Photocoagulation ◽

Current Evidence ◽

Adjunct Therapy ◽

Anti Vegf ◽

Laser Systems ◽

Retinal Photocoagulation

Vascular endothelial growth factor (anti-VEGF) inhibitors in action have demonstrated efficacy and safety in the treatment of diabetic macular edema (DME), and have changed both the goal and prospects for treatment of this disease. Consequently, the role of focal laser retinal photocoagulation in the treatment of DME has been actively debated. However, technical advances in new laser systems, treatment protocols for anti-VEGF drug research, and the functional impact of modern focal photocoagulation are necessary to assess the role of laser coagulation in the treatment of DME. A wide range of clinical studies of laser therapy was necessary as an additional treatment for 20 to 50 % of patients receiving monotherapy with anti-VEGF drugs in patients with diabetic macular edema. In addition, a lower frequency of repeated treatment and a more stable reduction in retinal thickness have been demonstrated in other studies. However, the lack of information about the laser systems used, their technical characteristics, and application protocols often make it difficult to compare directly the results of anti-VEGF tests. Therefore, the aim of our work was to analyze the currently available data related to the potential role of focal laser photocoagulation in the treatment of DME, including a detailed review of the most commonly used laser systems. The results obtained with sub-threshold diode micro-pulse laser photocoagulation may be a valuable option as an adjunct therapy to treatment with angiogenesis inhibitors. Current evidence suggests that focal laser therapy should still exist as an adjunct therapy for many patients.

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ETOILE: Real-World Evidence of 24 Months of Ranibizumab 0.5 mg in Patients with Visual Impairment Due to Diabetic Macular Edema

Clinical Ophthalmology ◽

10.2147/opth.s313081 ◽

2021 ◽

Vol Volume 15 ◽

pp. 2307-2315

Author(s):

Laurent Kodjikian ◽

Amelie Lecleire-Collet ◽

Corinne Dot ◽

Marie-Laure Le Lez ◽

Stéphanie Baillif ◽

...

Keyword(s):

Visual Impairment ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Real World ◽

Real World Evidence

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Treatment patterns in patients with age-related macular degeneration and diabetic macular edema: A real-world claims analysis in Dubai

PLoS ONE ◽

10.1371/journal.pone.0254569 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254569

Author(s):

Igor Kozak ◽

Avinash Gurbaxani ◽

Ammar Safar ◽

Prasan Rao ◽

Amal Masalmeh ◽

...

Keyword(s):

Macular Degeneration ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Real World ◽

Treatment Patterns ◽

Age Related Macular Degeneration ◽

Treatment Frequency ◽

Anti Vegf ◽

Age Related

Objectives To characterize the pattern of approved anti-vascular endothelial growth factor (VEGF) treatments among patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) in the United Arab Emirates (UAE). Method This was a retrospective, nonrandomized, observational cohort analysis of the Dubai Real-world Claims Database with a 360-day follow-up period. Adult patients diagnosed with nAMD or DME treated with ranibizumab or aflibercept for the first time were included. The primary objective was to evaluate anti-VEGF treatment patterns with respect to the proportion of patients receiving ranibizumab and aflibercept for nAMD and DME separately. Results Of the 451 patients included in the final study cohort, 83.6% and 16.4% had a diagnosis of DME (ranibizumab: 48.5%; aflibercept: 51.5%) and nAMD (ranibizumab: 40.5%; aflibercept: 59.5%), respectively, at baseline. Treatment frequency of ranibizumab/aflibercept was similar for nAMD (mean: 2.4/2.9 injections; p = 0.2389) with fewer injections in the ranibizumab cohort for DME (mean: 1.9/2.5 injections; p = 0.0002). Most patients received ≤3 anti-VEGF injections during the 360-day follow-up period. The time between consecutive treatments was large (nAMD: 73.6 days/10.5 weeks; DME: 80.5 days/11.5 weeks). Approximately 10%–13.5% of patients switched their anti-VEGF therapy. Most patients (83.8%) had a diabetes diagnosis during the follow-up period. Conclusions This real-world study provides an initial understanding of anti-VEGF treatment patterns in patients with nAMD and DME in the UAE. Treatment frequency of the 2 anti-VEGF agents assessed was similar in both patient populations. Both treatments were infrequently administered with large dosing intervals.

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