Saucedo Lucia, Pfister Isabel B, Schild Christin, Garweg Justus G
Swiss Eye Institute, Rotkreuz, Berner Augenklinik, Bern, Switzerland.
Department Ophthalmology, Inselspital, University of Bern, Bern, Switzerland.
Ophthalmol Sci. 2025 Jun 2;5(6):100838. doi: 10.1016/j.xops.2025.100838. eCollection 2025 Nov-Dec.
To assess the outcomes of treatment cessation due to disease stability in eyes with diabetic macular edema (DME).
A single-center, retrospective, consecutive case series.
Patients with DME who had received their first anti-VEGF treatment between 2012 and 2021, a Snellen best-corrected visual acuity (VA) ≥0.1, and a follow-up of ≥24 months.
Baseline characteristics, best-corrected VA, OCT biomarkers over time, and injection details were collected from patients' medical records. Treatment interruption was defined as a treatment-free interval of ≥25 weeks after the last injection for any reason. An active decision for treatment interruption due to a stable retinal situation was defined as treatment cessation. Data are presented as mean ± standard deviation.
Percentage of patients experiencing treatment cessation, time to treatment cessation and to reuptake, and change in best-corrected VA and central retinal thickness.
Beyond 109 eyes treated over ≥24 months, 81 eyes (62 patients) met the inclusion criteria. During a follow-up of 5.5 ± 2.3 (median 5) years, patients received 22.6 ± 14.9 (median 20) intravitreal injections, 7.7 ± 3.0 (8.0) of these in the first year. Fifty-seven eyes (70.4%) experienced ≥1 planned treatment cessation of ≥25 weeks, while 4 eyes experienced an unplanned treatment interruption. Treatment cessation was documented in 53 eyes (65.4%) 65.2 ± 52.4 (median 42) weeks after treatment initiation for 106.2 ± 110.4 (median 54) weeks. The reason for treatment cessation was patient-driven in 1 eye (1.9%; the patient wished to stop treatment against medical advice), physician-driven in 38 eyes (71.7%; stable VA, despite persisting residual retinal fluid in OCT), and OCT-driven in 14 eyes (26.4%; no retinal fluid in OCT). Baseline parameters were comparable between eyes experiencing treatment cessation and those which did not.
Treatment cessation was achieved in 70% of eyes with DME after intensive treatment during the first year. This calls for a discussion about a possible systematic assessment of disease stability by omitting a single injection in eyes with stable residual retinal fluid.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
评估因糖尿病性黄斑水肿（DME）病情稳定而停止治疗的眼部治疗效果。
单中心、回顾性、连续病例系列研究。
2012年至2021年间接受首次抗VEGF治疗、最佳矫正视力（Snellen视力表）≥0.1且随访时间≥24个月的DME患者。
从患者病历中收集基线特征、最佳矫正视力、随时间变化的OCT生物标志物以及注射详情。治疗中断定义为因任何原因在最后一次注射后无治疗间隔≥25周。因视网膜情况稳定而主动决定中断治疗定义为停止治疗。数据以均值±标准差表示。
停止治疗的患者百分比、停止治疗及重新开始治疗的时间、最佳矫正视力和中心视网膜厚度的变化。
在接受≥24个月治疗的109只眼中，81只眼（62例患者）符合纳入标准。在5.5±2.3（中位数5）年的随访期间，患者接受了22.6±14.9（中位数20）次玻璃体内注射，其中第一年为7.7±3.0（8.0）次。57只眼（70.4%）经历了≥1次计划内的≥25周治疗中断，而4只眼经历了非计划内的治疗中断。在治疗开始后65.2±52.4（中位数42）周，53只眼（65.4%）记录到停止治疗，持续时间为106.2±110.4（中位数54）周。停止治疗的原因中，1只眼（1.9%）是患者自行决定（患者不顾医生建议希望停止治疗）；38只眼（71.7%）是医生决定（尽管OCT显示仍有残留视网膜积液，但视力稳定）；14只眼（2
