Sugimoto Masahiko, Chujo Shinichiro, Kato Kumiko, Shimura Masahiko, Kitano Shigehiko, Kusuhara Sentaro, Terasaki Hiroto, Kondo Mineo
Department of Ophthalmology and Visual Science, Faculty of Medicine, Yamagata University, 2-2-2, Iida-nishi, Yamagata 990-9585, Yamagata, Japan.
Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu 514-8507, Mie, Japan.
J Clin Med. 2024 Dec 2;13(23):7336. doi: 10.3390/jcm13237336.
: The object of this study was to determine the outcomes of treatments other than anti-vascular endothelial growth factor (VEGF) therapy for diabetic macular edema (DME) before and after the approval of anti-VEGF therapy in Japan. : This was a retrospective study registered in the database of the Survey of Treatment for DME (STREAT-DME). A total of 1683 patients treated from 2010 to 2017 were included. The patients were divided into two groups: (1) a pre-group, treated before the approval of anti-VEGF agents (2010-2013, = 771), and (2) a post-group (2014-2017, = 912). Each group was further categorized based on best-corrected visual acuity (BCVA): (i) improved from poor (>0.3 logMAR units) to good (≤0.3 logMAR units) or (ii) decreased from good to poor. : In the pre-group, 18.5% of patients improved from poor to good BCVA out of the total patient population ( < 0.0001), along with 17.3% out of those administered anti-VEGF therapy ( = 0.139), 20.5% of those administered a sub-tenon injection of triamcinolone acetonide (STTA, = 0.02), 17.7% ( = 0.20) of those administered photocoagulation, and 14.2% of those who underwent pars plana vitrectomy (PPV, = 0.0001). In the post-group, 21.8% had improved BCVA out of the total patient population ( < 0.0001), along with 27.2% of those undergoing anti-VEGF therapy ( < 0.0001), 16.7% of those administered STTA ( < 0.0001), and 27.2% of those who underwent PPV ( < 0.0001). : STTA and PPV are effective to a certain extent, even after the approval of anti-VEGF agents.
本研究的目的是确定在日本批准抗血管内皮生长因子（VEGF）治疗之前和之后，用于治疗糖尿病性黄斑水肿（DME）的除抗VEGF治疗之外的其他治疗方法的疗效。
这是一项在糖尿病性黄斑水肿治疗调查（STREAT-DME）数据库中注册的回顾性研究。共纳入了2010年至2017年接受治疗的1683例患者。患者被分为两组：（1）治疗前组，在抗VEGF药物批准之前接受治疗（2010 - 2013年，n = 771）；（2）治疗后组（2014 - 2017年，n = 912）。每组进一步根据最佳矫正视力（BCVA）进行分类：（i）从差（>0.3 logMAR单位）改善到好（≤0.3 logMAR单位）；或（ii）从好变差。
在治疗前组中，在全部患者人群中，18.5%的患者BCVA从差改善到好（P < 0.0001），在接受抗VEGF治疗的患者中这一比例为17.3%（P = 0.139），接受曲安奈德球周注射（STTA）的患者中为20.5%（P = 0.02），接受光凝治疗的患者中为17.7%（P = 0.20），接受玻璃体切割术（PPV）的患者中为14.2%（P = 0.0001）。在治疗后组中，在全部患者人群中，21.8%的患者BCVA有所改善（P < 0.0001），接受抗VEGF治疗的患者中这一比例为27.2%（P < 0.0001），接受STTA的患者中为16.7%（P < 0.0001），接受PPV的患者中为27.2%（P < 0.0001）。
即使在抗VEGF药物批准之后，STTA和PPV在一定程度上仍是有效的。
