Título / Title

AN INTERNATIONAL COMPARISON OF BASELINE CHARACTERISTICS OF PATIENTS UNDERGOING INITIATION OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR DIABETIC MACULAR EDEMA

Introdução / Purpose

Diabetic macular edema (DME) is a leading cause of vision loss worldwide. The object of this study is to compare global differences of baseline characteristics of patients undergoing initiation of anti-vascular endothelial growth factor therapy for DME.

Material e Método / Methods

This multicenter (EUA, Argentina, Brazil, Costa Rica, Guatemala, India, and Korea) cross-sectional study included diabetic patients with foveal-involving retinal edema secondary to DME as documented by fundus exam and OCT, and undergoing initiation of intravitreal anti-VEGF drugs. Variables were collected to find possible risk factors and to create an epidemiological profile of DME patients undergoing initiation of anti-VEGF agents.

Resultados / Results

Nine hundred and two patients were selected. Mean age was 62.4(±11), 49.7% were Caucasians, 57.6% were male, 96% type two diabetes with an average disease duration of 181.7±113 months. 74.7% suffered from hypertension, 26.6% from cardiovascular disease, 12.1% from cerebrovascular disease, 12.8% from peripheral vascular disease, and 12.8% from renal insufficiency. BCVA was 65(±20) ETDRS letters, central subfield thickness was 364 (±162) µm, cube volume 11.1±3.1 mm3, cube average thickness 328.8±61 µm, and 63.9% had non-proliferative diabetic retinopathy. Comparison between US vs. international patients, and patients with BCVA≤70 letters vs. >70 letters were performed, significant differences were acknowledged, and risk factors were recognized.

Discussão e Conclusões / Conclusion

BCVA and OCT measurements were significantly worse in the international cohort (p<0.001).The international cohort also showed a higher rate of laser (PRP and focal) treatment and surgery history (p<0.001). Systolic blood pressure (p=0.001), blood creatinine (p=0.003), and BUN (p=0.003) were significantly different and above normal range in the US cohort.The North American cohort presented higher rates of hypertension history (p<0.001), cardiovascular (p=0.003), cerebrovascular, peripheral vascular disease, and renal insufficiency (p<0.001 all)

Palavras Chave

diabetic macular edema; anti-vascular endothelial growth factor; diabetic retinopathy