Factors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study

Sing Yue Sim,1 Arevik Ghulakhszian,2 Amal Minocha,1 Dhannie Ramcharan,2 Soroush Nokhostin,3 Richard Cheong-Leen,1 Sheena George,1 Esther Posner,3 Christiana Dinah2 1Department of Ophthalmology, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK; 2Department of Ophthalmology, London North We...

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Autores principales:	Sim SY, Ghulakhszian A, Minocha A, Ramcharan D, Nokhostin S, Cheong-Leen R, George S, Posner E, Dinah C
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	diabetic macula oedema functional and anatomical response to aflibercept Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/e053bf9ab6514aaca7783976f516b13a
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spelling	oai:doaj.org-article:e053bf9ab6514aaca7783976f516b13a2021-12-02T14:44:22ZFactors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study1177-5483https://doaj.org/article/e053bf9ab6514aaca7783976f516b13a2021-05-01T00:00:00Zhttps://www.dovepress.com/factors-influencing-response-to-aflibercept-in-diabetic-macular-oedema-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Sing Yue Sim,1 Arevik Ghulakhszian,2 Amal Minocha,1 Dhannie Ramcharan,2 Soroush Nokhostin,3 Richard Cheong-Leen,1 Sheena George,1 Esther Posner,3 Christiana Dinah2 1Department of Ophthalmology, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK; 2Department of Ophthalmology, London North West University Healthcare NHS Trust, London, UK; 3Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, UKCorrespondence: Christiana Dinah Email christiana.dinah@nhs.netBackground: Diabetic macular oedema (DMO) is the leading cause of sight impairment in working age populations in developed countries. Current first line treatment for centre-involving DMO involves intravitreal anti-VEGF but treatment response can be variable. In this retrospective, real world, multi-centre cohort study, we aim to identify ocular and systemic characteristics that correlate with anatomical and functional outcomes for treatment-naive DMO patients treated with intravitreal aflibercept.Methods: Retrospective multicentre cohort study of treatment-naive DMO patients initiated on aflibercept at three North West London hospitals between 2016 and 2018. Baseline systemic and ocular factors, best corrected visual acuity (BCVA) and central macular thickness (CMT) at 12 months were determined and statistically analysed.Results: A total of 270 eyes of 221 DMO patients met inclusion criteria. Mean age was 62.8 ± 12.1, mean baseline HbA1c was 67 ± 20 mmol/mol, and mean eGFR was 72 mL/min/1.7m2. Mean number of aflibercept injections at 12 months was 6.2. Better baseline BCVA, lower baseline CMT, and absence of epiretinal membrane (ERM) were associated with better BCVA at 12 months whilst lower baseline CMT and proliferative retinopathy status were associated with lower CMT at 12 months.Conclusion: Our study is the largest real-world dataset examining factors influencing functional and anatomical response to aflibercept in DMO in the UK. Older age, lower baseline BCVA, higher baseline CMT and more severe diabetic retinopathy were associated with poorer visual acuity at 12 months and prioritisation of these patients within a pressured healthcare setting is recommended.Keywords: diabetic macular oedema, functional and anatomical response to AfliberceptSim SYGhulakhszian AMinocha ARamcharan DNokhostin SCheong-Leen RGeorge SPosner EDinah CDove Medical Pressarticlediabetic macula oedemafunctional and anatomical response to afliberceptOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 2089-2097 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetic macula oedema functional and anatomical response to aflibercept Ophthalmology RE1-994
spellingShingle	diabetic macula oedema functional and anatomical response to aflibercept Ophthalmology RE1-994 Sim SY Ghulakhszian A Minocha A Ramcharan D Nokhostin S Cheong-Leen R George S Posner E Dinah C Factors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study
description	Sing Yue Sim,1 Arevik Ghulakhszian,2 Amal Minocha,1 Dhannie Ramcharan,2 Soroush Nokhostin,3 Richard Cheong-Leen,1 Sheena George,1 Esther Posner,3 Christiana Dinah2 1Department of Ophthalmology, The Hillingdon Hospitals NHS Foundation Trust, Uxbridge, UK; 2Department of Ophthalmology, London North West University Healthcare NHS Trust, London, UK; 3Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, UKCorrespondence: Christiana Dinah Email christiana.dinah@nhs.netBackground: Diabetic macular oedema (DMO) is the leading cause of sight impairment in working age populations in developed countries. Current first line treatment for centre-involving DMO involves intravitreal anti-VEGF but treatment response can be variable. In this retrospective, real world, multi-centre cohort study, we aim to identify ocular and systemic characteristics that correlate with anatomical and functional outcomes for treatment-naive DMO patients treated with intravitreal aflibercept.Methods: Retrospective multicentre cohort study of treatment-naive DMO patients initiated on aflibercept at three North West London hospitals between 2016 and 2018. Baseline systemic and ocular factors, best corrected visual acuity (BCVA) and central macular thickness (CMT) at 12 months were determined and statistically analysed.Results: A total of 270 eyes of 221 DMO patients met inclusion criteria. Mean age was 62.8 ± 12.1, mean baseline HbA1c was 67 ± 20 mmol/mol, and mean eGFR was 72 mL/min/1.7m2. Mean number of aflibercept injections at 12 months was 6.2. Better baseline BCVA, lower baseline CMT, and absence of epiretinal membrane (ERM) were associated with better BCVA at 12 months whilst lower baseline CMT and proliferative retinopathy status were associated with lower CMT at 12 months.Conclusion: Our study is the largest real-world dataset examining factors influencing functional and anatomical response to aflibercept in DMO in the UK. Older age, lower baseline BCVA, higher baseline CMT and more severe diabetic retinopathy were associated with poorer visual acuity at 12 months and prioritisation of these patients within a pressured healthcare setting is recommended.Keywords: diabetic macular oedema, functional and anatomical response to Aflibercept
format	article
author	Sim SY Ghulakhszian A Minocha A Ramcharan D Nokhostin S Cheong-Leen R George S Posner E Dinah C
author_facet	Sim SY Ghulakhszian A Minocha A Ramcharan D Nokhostin S Cheong-Leen R George S Posner E Dinah C
author_sort	Sim SY
title	Factors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study
title_short	Factors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study
title_full	Factors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study
title_fullStr	Factors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study
title_full_unstemmed	Factors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study
title_sort	factors influencing response to aflibercept in diabetic macular oedema patients in a diverse north west london population: a real-world study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/e053bf9ab6514aaca7783976f516b13a
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Factors Influencing Response to Aflibercept in Diabetic Macular Oedema Patients in a Diverse North West London Population: A Real-World Study

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