PMID- 35027613 OWN - NLM STAT- MEDLINE DCOM- 20220228 LR - 20220228 IS - 2045-2322 (Electronic) IS - 2045-2322 (Linking) VI - 12 IP - 1 DP - 2022 Jan 13 TI - Diabetic macular edema and proliferative diabetic retinopathy treated with anti-vascular endothelial growth factor under the reimbursement policy in Taiwan. PG - 711 LID - 10.1038/s41598-021-04593-x [doi] LID - 711 AB - The purpose of this retrospective interventional case series is to compare the functional and anatomical outcomes in eyes with diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) treated intravitreally with aflibercept or ranibizumab under the Taiwan National Insurance Bureau reimbursement policy. 84 eyes were collected and all eyes were imaged with spectral-domain optical coherence tomography (SD-OCT), color fundus photographs (CFPs), and fluorescein angiography (FA). At 24 months after therapy initiation, the logMAR BCVA improved from 0.58 +/- 0.33 to 0.47 +/- 0.38 (p < 0.01), the CRT decreased from 423.92 +/- 135.84 to 316.36 +/- 90.02 (p < 0.01), and the number of microaneurysms decreased from 142.14 +/- 57.23 to 75.32 +/- 43.86 (p < 0.01). The mean injection count was 11.74 +/- 5.44. There was no intergroup difference in logMAR BCVA (p = 0.96), CRT (p = 0.69), or injection count (p = 0.81). However, the mean number of microaneurysms was marginally reduced (p = 0.06) in eyes treated with aflibercept at the end of the follow-up, and the incidence rates of supplementary panretinal photocoagulation (PRP) (p = 0.04) and subthreshold micropulse laser (SMPL) therapy sessions (p = 0.01) were also reduced. Multivariate analysis revealed that only initial logMAR BCVA influenced the final VA improvements (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.21 ~ 0.93, p < 0.01); in contrast, age (OR - 0.38, 95% CI - 6.97 ~ - 1.85, p < 0.01) and initial CRT (OR 0.56, 95% CI 0.34 ~ 0.84, p < 0.01) both influenced the final CRT reduction at 24 months. To sum up, both aflibercept and ranibizumab are effective in managing DME with PDR in terms of VA, CRT and MA count. Eyes receiving aflibercept required less supplementary PRP and SMPL treatment than those receiving ranibizumab. The initial VA influenced the final VA improvements at 24 months, while age and initial CRT were prognostic predictors of 24-month CRT reduction. CI - (c) 2022. The Author(s). FAU - Hsieh, Ming-Chieh AU - Hsieh MC AD - Department of Ophthalmology, Eye center, China Medical University Hospital, Taichung City, Taiwan. AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. FAU - Cheng, Chieh-Yin AU - Cheng CY AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. FAU - Li, Kun-Hsien AU - Li KH AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. FAU - Chuang, Chih-Chun AU - Chuang CC AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. FAU - Wu, Jian-Sheng AU - Wu JS AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. FAU - Lee, Sheng-Ta AU - Lee ST AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. FAU - Lu, Wei-Yang AU - Lu WY AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. FAU - Chiu, Shin-Lin AU - Chiu SL AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. AD - College of Nursing and Health Sciences, Da-Yeh University, Changhua City, Taiwan. FAU - Liu, Yu-Ling AU - Liu YL AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. FAU - Chen, San-Ni AU - Chen SN AD - Department of Ophthalmology, Eye center, China Medical University Hospital, Taichung City, Taiwan. Sanchen52@gmail.com. AD - Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan. Sanchen52@gmail.com. AD - Department of Ophthalmology, China Medical University, Taichung City, Taiwan. Sanchen52@gmail.com. AD - Department of Optometry, Da-Yeh University, Changhua City, Taiwan. Sanchen52@gmail.com. AD - School of Medicine, Chung-Shan Medical University, Taichung, Taiwan. Sanchen52@gmail.com. LA - eng PT - Journal Article DEP - 20220113 PL - England TA - Sci Rep JT - Scientific reports JID - 101563288 RN - 0 (Recombinant Fusion Proteins) RN - 15C2VL427D (aflibercept) RN - EC 2.7.10.1 (Receptors, Vascular Endothelial Growth Factor) RN - ZL1R02VT79 (Ranibizumab) SB - IM MH - Aged MH - *Diabetes Complications MH - Diabetic Retinopathy/diagnostic imaging/*therapy MH - Female MH - Humans MH - *Insurance, Health, Reimbursement MH - Laser Coagulation MH - Light Coagulation MH - Macular Edema/diagnostic imaging/etiology/*therapy MH - Male MH - Middle Aged MH - *National Health Programs MH - Prognosis MH - Ranibizumab/administration & dosage/*therapeutic use MH - Receptors, Vascular Endothelial Growth Factor/administration & dosage/*therapeutic use MH - Recombinant Fusion Proteins/administration & dosage/*therapeutic use MH - Retrospective Studies MH - Taiwan MH - Time Factors MH - Treatment Outcome PMC - PMC8758685 COIS- The authors declare no competing interests. EDAT- 2022/01/15 06:00 MHDA- 2022/03/01 06:00 PMCR- 2022/01/13 CRDT- 2022/01/14 05:52 PHST- 2021/06/29 00:00 [received] PHST- 2021/12/20 00:00 [accepted] PHST- 2022/01/14 05:52 [entrez] PHST- 2022/01/15 06:00 [pubmed] PHST- 2022/03/01 06:00 [medline] PHST- 2022/01/13 00:00 [pmc-release] AID - 10.1038/s41598-021-04593-x [pii] AID - 4593 [pii] AID - 10.1038/s41598-021-04593-x [doi] PST - epublish SO - Sci Rep. 2022 Jan 13;12(1):711. doi: 10.1038/s41598-021-04593-x.