Evidence map›Paper›PMID 37016462›Full record

ArticleInternational journal of retina and vitreous2023

Predictive factors for treatment outcomes with intravitreal anti-vascular endothelial growth factor injections in diabetic macular edema in clinical practice.

Rajya L Gurung, Liesel M FitzGerald, Ebony Liu, Bennet J McComish, Georgia Kaidonis, Bronwyn Ridge, Alex W Hewitt, Brendan J Vote, Nitin Verma, Jamie E Craig and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of retina and vitreous, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
9.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Efficacy of anti-VEGF monotherapy versus anti-VEGF therapy with subthreshold micropulse laser (SML) in the management of diabetic macular oedema (DMO): a systematic review and meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024
    Pooled it
  2. Review
  3. Risk of excessive macular thinning in diabetic macular edema with ellipsoid zone disruption treated with anti-VEGF: 2-year real-world evidence.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Rajya L GurungMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street (Private Bag 23), Hobart, TAS, 7000, Australia. rajyalaxmi.gurung@utas.edu.au.
Liesel M FitzGeraldMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street (Private Bag 23), Hobart, TAS, 7000, Australia.
Ebony LiuDepartment of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia.
Bennet J McComishMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street (Private Bag 23), Hobart, TAS, 7000, Australia.
Georgia KaidonisDepartment of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia.
Bronwyn RidgeDepartment of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia.
Alex W HewittMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street (Private Bag 23), Hobart, TAS, 7000, Australia.
Brendan J VoteSchool of Medicine, University of Tasmania, Hobart, TAS, Australia.
Nitin VermaSchool of Medicine, University of Tasmania, Hobart, TAS, Australia.
Jamie E CraigDepartment of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia.
Kathryn P BurdonMenzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street (Private Bag 23), Hobart, TAS, 7000, Australia.
University of Tasmania · AUFlinders University · AU

Funding

Diabetes Tasmania Post graduate research scholarship Diabetes Tasmania Post graduate research scholarshipGerald Harvey Senior Research Fellowship Gerald Harvey Senior Research FellowshipNational Health and Medical Research Council (NHMRC) Australia Centre for Research Excellence GNT1116360Patricia F Gordon Top Up Scholarship Patricia F Gordon Top Up ScholarshipRoyal Hobart Hospital Research Foundation Royal Hobart Hospital Research FoundationTasmanian Community Fund Tasmanian Community FundWilliams Oncology Royal Hobart Hospital Research Foundation Grant Williams Oncology Royal Hobart Hospital Research Foundation Grant
6 · The paper itself

Abstract

backgroundIntravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are the standard of care for diabetic macular edema (DME), a common complication of diabetes. This study aimed to identify factors influencing DME intravitreal anti-VEGF treatment outcomes in real-world practice.

methodsThis was a multi-center retrospective observational study using medical chart review of participants receiving anti-VEGF injections for DME (N = 248). Demographic and clinical variables were assessed for association with best corrected visual acuity (BCVA) and central macular thickness (CMT) outcomes using regression models.

resultsThere was a significant improvement in BCVA (p < 0.001) and CMT (p < 0.001) after 12 months of treatment, although 21% of participants had decreased BCVA, and 41% had a < 10% CMT reduction at 12 months. Higher baseline BCVA (p = 0.022, OR=-0.024, 95% CI=-0.046,-0.004) and longer duration of diabetic retinopathy (p = 0.048, OR=-0.064, 95% CI=-0.129,-0.001) were negative predictors for BCVA response, whereas Aflibercept treatment (p = 0.017, OR = 1.107, 95% CI = 0.220,2.051) compared with other drugs and a positive "early functional response" (p < 0.001, OR=-1.393, 95% CI=-1.946,-0.857) were positive predictors. A higher baseline CMT (p < 0.001, OR = 0.019, 95% CI = 0.012,0.0261) and an "early anatomical response", (p < 0.001, OR=-1.677, 95% CI=-2.456, -0.943) were predictors for greater reduction in CMT. Overall, the variables could predict only 23% of BCVA and 52% of CMT response.

conclusionsThe study shows a significant proportion of DME patients do not respond to anti-VEGF therapy and identifies several clinical predictors for treatment outcomes.

trial registrationThe study was approved through the Human Research Ethics Committee, University of Tasmania (approval number H0012902), and the Southern Adelaide Clinical Human Research Ethics Committee (approval number 86 - 067).

Indexed as

Anti-VEGFBest-corrected visual acuityCentral macular thicknessDiabetic macular edema

Identifiers

PMID37016462
PMCPMC10074667
OpenAlexW4362553594

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.