Evidence map›Paper›PMID 39736584›Full record

ArticleBMC ophthalmology2024

How intravitreal anti-vascular endothelial growth factor initial dosing impacts patient outcomes in diabetic macular oedema.

Rishi P Singh, David Tabano, Blanche L Kuo, Andrew LaPrise, Theodore Leng, Eunice Kim, Meghan Hatfield, Vincent Garmo

Abstract read
In one paragraph

Article in BMC ophthalmology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Topical losartan ophthalmic drops - a review of corneal wound healing and topical losartan for managing corneal haze and potential future indications.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
    Pooled it
  2. Review
  3. Article
  4. Article
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

8 authors.

Rishi P SinghCenter for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, 44106, USA. drrishisingh@gmail.com.
David TabanoGenentech, Inc, South San Francisco, CA, USA.
Blanche L KuoCenter for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, 44106, USA.
Andrew LaPriseVerana Health, San Francisco, CA, USA.
Theodore LengByers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, CA, USA.
Eunice KimGenentech, Inc, South San Francisco, CA, USA.
Meghan HatfieldVerana Health, San Francisco, CA, USA.
Vincent GarmoGenentech, Inc, South San Francisco, CA, USA.

Funding

Stanford Vision Research CoreP30EY026877 · NEI · STANFORD UNIVERSITY · PI Jeffrey L Goldberg · 2017 to 2026
$8.0M
Genentech Study support, medical writing supportNEI NIH HHS P30 EY026877NIH HHS P30-EY026877
6 · The paper itself

Abstract

backgroundIntravitreal anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular oedema (DME) may begin with several initial monthly doses. Characteristics, treatment patterns and outcomes were compared for eyes with DME that did and did not receive such initial doses.

methodsThis was a retrospective database study using American Academy of Ophthalmology Intelligent Research in Sight

resultsIncluded were 217,696 eyes (n = 77,769 initial; n = 139,927 non-initial) from 166,868 patients. Mean (SD) baseline VA was numerically higher for eyes with versus without initial doses (63.0 [18.1] vs. 62.5 [19.8] letters); this remained during follow-up. Based on modelling results, Eyes with initial doses received more injections (mean [standard deviation (SD)] 11.6 [8.9] vs. 6.1 [6.8] injections) more frequently (interval 7.6 [2.8] vs. 12.6 [7.7] weeks) than eyes without. These differences occurred across follow-up years. Discontinuation (45.7% vs. 63.8%), re-initiation (17.2% vs. 25.0%), and switch (24.5% vs. 31.5%) were less common with initial doses. Asian, Black, and patients of other/unknown race were less likely (P < 0.01) to receive initial doses than White patients, as were Medicare/Medicaid-insured patients versus commercially insured patients (P < 0.01).

conclusionsVarious sociodemographic factors associate with initial anti-VEGF doses, including race, ethnicity and insurance. Although eyes with frequent initial doses maintained higher VA than those without, they also receive more injections over time. Further research may elucidate the impact of frequent initial doses versus total injection number on DME outcomes.

Indexed as

Angiogenesis InhibitorsBevacizumabDiabetic RetinopathyIntravitreal InjectionsMacular EdemaRanibizumabVascular Endothelial Growth Factor AVisual AcuityAgedDose-Response Relationship, DrugFemaleFollow-Up StudiesHumansMaleMiddle AgedReceptors, Vascular Endothelial Growth FactorAngiogenesis InhibitorsBevacizumabRanibizumabReceptors, Vascular Endothelial Growth FactorVascular Endothelial Growth Factor AAnti-vascular endothelial growth factorDiabetic macular oedemaIntravitreal injectionsLoading dose

Identifiers

PMID39736584
PMCPMC11684133

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Registered trials

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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.