Clinical Outcomes of anti-VEGF intravitreal injection in Patients with diabetic retinopathy
DOI:
https://doi.org/10.5281/zenodo.22812280Keywords:
anti-VEGF, diabetic retinopathy, diabetic macular edema, intravitreal injection, afliberceptAbstract
Background: Intravitreal anti-VEGF therapy is now the dominant treatment for diabetic macular edema and an alternative to panretinal photocoagulation for proliferative retinopathy, following evidence that intraocular VEGF drives both processes [4].
Objective: This review synthesizes clinical outcomes of ranibizumab, aflibercept, and bevacizumab intravitreal injection in diabetic retinopathy, including comparative efficacy, treat-and-extend durability, and regression of retinopathy severity.
Methods: We synthesized randomized trials, extension studies, and large registries addressing anti-VEGF therapy for diabetic macular edema and retinopathy, including DRCR.net Protocol T, S, and V, and the RISE/RIDE, VISTA/VIVID, BOLT, TREX-DME, and PANORAMA programs [6,27].
Findings: Aflibercept, ranibizumab, and bevacizumab produce similar 1-year gains of roughly 8-12 letters, aflibercept modestly favored in worse-acuity eyes [6]; treat-and-extend preserves efficacy while lowering injection burden [23]; and anti-VEGF monotherapy induces regression of retinopathy severity and can substitute for panretinal photocoagulation [27,31].
Conclusions: Anti-VEGF injection delivers durable benefit across retinopathy severity, though real-world outcomes stay limited by undertreatment relative to trial dosing [25].
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