ArticleEye (London, England)2025
Visual and anatomical failure of anti-VEGF therapy for retinal vascular diseases: a survival analysis of real-world data.
Article in Eye (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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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.
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.
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Who cites it
9 citing papers in PubMed.
- Wnt Pathway Agonism as a Therapeutic Strategy for Retinal Vascular Diseases: A Narrative Review of Evidence to Date.Ophthalmology and therapy · 2026Review
- Response to anti-VEGF injections for diabetic macular edema among patients on chronic exogenous insulin therapy.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Single-cell insights into maladaptive endothelial plasticity and therapeutic targets in diabetic vascular complications.Cardiovascular diabetology · 2026Review
- Silencing of lncRNA HOTAIR Using Eyedrops as a Potential Treatment for Diabetes-Associated Retinal Dysregulation and Dysfunction.Investigative ophthalmology & visual science · 2026Article
- The impact of anti-vascular endothelial growth factor therapy on the activation status of retinal macrophages/microglia in patients with diabetic retinopathy and familial exudative vitreoretinopathy and its association with treatment response.American journal of translational research · 2026Article
- Efficacy and Safety of Ranibizumab Combined with Dexamethasone Intravitreal Implant Sequential Therapy for Macular Edema Secondary to Non-Ischemic Retinal Vein Occlusion.Drug design, development and therapy · 2026Article
- Systemic factors associated with poor anatomical response to anti-VEGF therapy in patients with diabetic macular edema: evidence from a large clinical cohort.Frontiers in endocrinology · 2026Article
- The economic impact of retinal diseases for which gene therapy is emerging: a systematic literature review.Health economics review · 2025Review
- Enhancing the understanding of anti-VEGF treatment failure in retinal vascular diseases: a call for expanded analyses and threshold validation.Eye (London, England) · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
importancePredicting undesirable outcomes following anti-VEGF initiation in macular oedema is critical for effective clinical decision-making and optimised care.
objectiveTo estimate the time to undesirable events in diabetic macular oedema (DMO), central and branch vein occlusions (CRVO and BRVO) after appropriate loading doses with either ranibizumab or aflibercept and identified baseline predictors of negative outcome. DESIGN, SETTING,
participantsA retrospective cohort study of 3277 patients (N = 2107 in DMO, N = 413 in CRVO and N = 757 in BRVO) collected over a 10-year period, in a large UK tertiary centre. Only one eye was included per patient. Inclusion criteria pre-specified a minimum of two clinic visits with one being at least 6 months post treatment. MAIN OUTCOME AND MEASURES: The main outcome measure was absence of visual acuity (VA) improvement due to macular oedema failure of anti-VEGF therapy (defined as VA gain <5 ETDRS letters and CST increase of 50 µm or CST > 325 µm) modelled using time-event analyzes of appropriately loaded patients. Secondary outcomes included survival curves by individual condition (DMO, CRVO, BRVO) and factors associated with negative outcomes.
resultsAfter starting anti-VEGF, there was a 50% chance of undesirable outcomes at 2.3, 5.24 and 6.16 years for DMO, CRVO and BRVO, respectively. Cox proportional hazards modelling identified presenting age, intraretinal (IRF) volume, presence of DMO and VA as predictors of negative outcomes, whilst South East Asian ethnicity conferred an independent protective effect.
conclusionReal-world data suggest that undesirable events following anti-VEGF injections is likely to in 50% of patients by the third year of treatment in spite of appropriate loading. The definition of undesirable treatment events captured nearly all patients who were escalated to another therapy, but this proportion represented a small percentage of our definition of failed response.
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Registered trials
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