Evolving Treatment Patterns in Diabetic Macular Edema Between 2015 and 2020

Area of Science:

• Ophthalmology
• Retinal Diseases
• Diabetic Retinopathy

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Understanding treatment trends is crucial for optimizing patient outcomes.

Purpose of the Study:

• To analyze the evolution of DME treatment practices in the United States over a five-year period (2015-2020).
• To identify changes in the utilization of anti-VEGF agents, steroids, focal laser, and untreated cases.

Main Methods:

• Retrospective analysis of 306,700 eyes with newly diagnosed DME from the Vestrum Health database (January 2015 - October 2020).
• Calculation of year-over-year and cumulative 5-year treatment distributions.
• Assessment of changes in visual acuity from baseline.

Main Results:

• Significant shifts in treatment patterns observed: untreated cases decreased (32.7% to 27.7%), anti-VEGF monotherapy increased (43.5% to 61.8%), and focal laser monotherapy declined (9.7% to 3.0%).
• Steroid monotherapy use remained stable (0.9% to 0.7%).
• Among eyes with 5-year follow-up, 77.5% received anti-VEGF therapy, and vision gains remained stable (3.6 to 3.5 letters).

Conclusions:

• DME treatment evolved towards increased anti-VEGF monotherapy and decreased focal laser use between 2015 and 2020.
• Steroid monotherapy use remained consistent, while the proportion of untreated eyes diminished.
• These evolving patterns were associated with sustained visual acuity improvements in treated patients.