The effect of insulin on response to intravitreal anti-VEGF injection in diabetic macular edema in type 2 diabetes mellitus

• Published in: BMC ophthalmology Vol. 22; no. 1; p. 94
• Main Authors: Gurung, Rajya L, FitzGerald, Liesel M, Liu, Ebony, McComish, Bennet J, Kaidonis, Georgia, Ridge, Bronwyn, Hewitt, Alex W, Vote, Brendan Jt, Verma, Nitin, Craig, Jamie E, Burdon, Kathryn P
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 28.02.2022; BioMed Central; BMC
• Subjects: Angiogenesis Inhibitors - therapeutic use; Anti-VEGF; Central macular thickness; Comparative analysis; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes therapy; Diabetic macular edema; Diabetic Retinopathy - complications; Diabetic Retinopathy - drug therapy; Dropsy; Edema; Glycosylated hemoglobin; Humans; Insulin; Insulin - therapeutic use; Intravitreal Injections; Macular Edema - drug therapy; Macular Edema - etiology; Retrospective Studies; Treatment Outcome; Type 2 diabetes; Vascular endothelial growth factor; Visual Acuity; Visual acuity; Anti-VEGF; Central macular thickness; Insulin; Diabetic macular edema
• ISSN: 1471-2415; 1471-2415
• DOI: 10.1186/s12886-022-02325-x

To assess whether insulin therapy impacts the effectiveness of anti-vascular endothelial growth factor (anti-VEGF) injection for the treatment of diabetic macular edema (DME) in type 2 diabetes mellitus. This was a retrospective multi-center analysis. The best-corrected visual acuity (BCVA) at 12 months, BCVA change, central macular thickness (CMT), CMT change, and cumulative injection number were compared between the insulin and the oral hypoglycemic agent (OHA) groups. The mean final BCVA and CMT improved in both the insulin (N = 137; p < 0.001; p < 0.001, respectively) and the OHA group (N = 61; p = 0.199; p < 0.001, respectively). The two treatment groups were comparable for final BCVA (p = 0.263), BCVA change (p = 0.184), final CMT (p = 0.741), CMT change (p = 0.458), and the cumulative injections received (p = 0.594). The results were comparable between the two groups when stratified by baseline vision (p > 0.05) and baseline HbA1c (p > 0.05). Insulin therapy does not alter treatment outcomes for anti-VEGF therapy in DME.