Uğur Yayla, Mehmet Orkun Sevik, Veysel Levent Karabaş, Özlem Şahin, Abdullah Özkaya, Nursal Melda Yenerel, Banu Açıkalın Öncel, Fatih Bilgehan Kaplan, Ecem Önder Tokuç, Hatice Selen Kanar, Işıl Kutlutürk Karagöz, Ece Başaran Emengen, Ayşe Demirciler Sönmez, Aslan Aykut, Utku Limon, Erdinç Bozkurt, Işılay Özsoy Saygın, Tuğba Aydoğan Gezginaslan, Özlem Aydın Öncü, Esra Türkseven Kumral, Nimet Yeşim Erçalık, Erkan Çelik
{"title":"土耳其玻璃体内抗血管内皮生长因子治疗糖尿病黄斑水肿的实际结果:MARMASIA研究组报告1号","authors":"Uğur Yayla, Mehmet Orkun Sevik, Veysel Levent Karabaş, Özlem Şahin, Abdullah Özkaya, Nursal Melda Yenerel, Banu Açıkalın Öncel, Fatih Bilgehan Kaplan, Ecem Önder Tokuç, Hatice Selen Kanar, Işıl Kutlutürk Karagöz, Ece Başaran Emengen, Ayşe Demirciler Sönmez, Aslan Aykut, Utku Limon, Erdinç Bozkurt, Işılay Özsoy Saygın, Tuğba Aydoğan Gezginaslan, Özlem Aydın Öncü, Esra Türkseven Kumral, Nimet Yeşim Erçalık, Erkan Çelik","doi":"10.4274/tjo.galenos.2023.56249","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to report the demographic and clinical characteristics of diabetic macular edema (DME) patients treated with intravitreal injection (IVI) of anti-vascular endothelial growth factors (anti-VEGF) and provide an overview of outcomes during routine clinical practice in Türkiye.</p><p><strong>Materials and methods: </strong>This retrospective, real-world study included 1,372 eyes (854 patients) treated with a pro re nata protocol by 21 ophthalmologists from 8 tertiary clinics on the Asian side of the Marmara region of Türkiye (MARMASIA Study Group). Five cohort groups were established by collecting the patients' baseline and 3, 6, 12, 24, and 36-month follow-up data, where each subsequent cohort may include the previous. Changes in best-corrected visual acuity (BCVA, approximate ETDRS letters) and central macular thickness (CMT, μm), number of visits and IVI, and rates of anti-VEGF switch and intravitreal dexamethasone implant (IDI) combination were evaluated.</p><p><strong>Results: </strong>The 3, 6, 12, 24, and 36-month cohorts included 1372 (854), 1352 (838), 1185 (722), 972 (581), and 623 (361) eyes (patients), respectively. The mean baseline BCVA and CMT were 51.4±21.4 letters and 482.6±180.3 μm. The mean changes from baseline in BCVA were +7.6, +9.1, +8.0, +8.6, and +8.4 letters, and in CMT were -115.4, -140.0, -147.9, -167.3, and -215.4 μm at the 3, 6, 12, 24, and 36-month visits (p<0.001 for all). The median cumulative number of anti-VEGF IVI was 3.0, 3.0, 5.0, 7.0, and 9.0, respectively. The overall anti-VEGF switch and IDI combination rates were 18.5% (253/1372 eyes) and 35.0% (480/1372 eyes), respectively.</p><p><strong>Conclusion: </strong>This largest real-life study of DME from Türkiye demonstrated BCVA gains inferior to randomized controlled trials, mainly due to the lower number of IVI. However, with the lower baseline BCVA and higher IDI combination rates in our cohorts, these gains were relatively superior to other real-life study counterparts.</p>","PeriodicalId":23373,"journal":{"name":"Turkish Journal of Ophthalmology","volume":" ","pages":"356-368"},"PeriodicalIF":0.0000,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10750085/pdf/","citationCount":"0","resultStr":"{\"title\":\"Real-World Outcomes of Intravitreal Anti-Vascular Endothelial Growth Factor Treatment for Diabetic Macular Edema in Türkiye: MARMASIA Study Group Report No. 1.\",\"authors\":\"Uğur Yayla, Mehmet Orkun Sevik, Veysel Levent Karabaş, Özlem Şahin, Abdullah Özkaya, Nursal Melda Yenerel, Banu Açıkalın Öncel, Fatih Bilgehan Kaplan, Ecem Önder Tokuç, Hatice Selen Kanar, Işıl Kutlutürk Karagöz, Ece Başaran Emengen, Ayşe Demirciler Sönmez, Aslan Aykut, Utku Limon, Erdinç Bozkurt, Işılay Özsoy Saygın, Tuğba Aydoğan Gezginaslan, Özlem Aydın Öncü, Esra Türkseven Kumral, Nimet Yeşim Erçalık, Erkan Çelik\",\"doi\":\"10.4274/tjo.galenos.2023.56249\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aimed to report the demographic and clinical characteristics of diabetic macular edema (DME) patients treated with intravitreal injection (IVI) of anti-vascular endothelial growth factors (anti-VEGF) and provide an overview of outcomes during routine clinical practice in Türkiye.</p><p><strong>Materials and methods: </strong>This retrospective, real-world study included 1,372 eyes (854 patients) treated with a pro re nata protocol by 21 ophthalmologists from 8 tertiary clinics on the Asian side of the Marmara region of Türkiye (MARMASIA Study Group). Five cohort groups were established by collecting the patients' baseline and 3, 6, 12, 24, and 36-month follow-up data, where each subsequent cohort may include the previous. Changes in best-corrected visual acuity (BCVA, approximate ETDRS letters) and central macular thickness (CMT, μm), number of visits and IVI, and rates of anti-VEGF switch and intravitreal dexamethasone implant (IDI) combination were evaluated.</p><p><strong>Results: </strong>The 3, 6, 12, 24, and 36-month cohorts included 1372 (854), 1352 (838), 1185 (722), 972 (581), and 623 (361) eyes (patients), respectively. The mean baseline BCVA and CMT were 51.4±21.4 letters and 482.6±180.3 μm. The mean changes from baseline in BCVA were +7.6, +9.1, +8.0, +8.6, and +8.4 letters, and in CMT were -115.4, -140.0, -147.9, -167.3, and -215.4 μm at the 3, 6, 12, 24, and 36-month visits (p<0.001 for all). The median cumulative number of anti-VEGF IVI was 3.0, 3.0, 5.0, 7.0, and 9.0, respectively. 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Real-World Outcomes of Intravitreal Anti-Vascular Endothelial Growth Factor Treatment for Diabetic Macular Edema in Türkiye: MARMASIA Study Group Report No. 1.
Objectives: This study aimed to report the demographic and clinical characteristics of diabetic macular edema (DME) patients treated with intravitreal injection (IVI) of anti-vascular endothelial growth factors (anti-VEGF) and provide an overview of outcomes during routine clinical practice in Türkiye.
Materials and methods: This retrospective, real-world study included 1,372 eyes (854 patients) treated with a pro re nata protocol by 21 ophthalmologists from 8 tertiary clinics on the Asian side of the Marmara region of Türkiye (MARMASIA Study Group). Five cohort groups were established by collecting the patients' baseline and 3, 6, 12, 24, and 36-month follow-up data, where each subsequent cohort may include the previous. Changes in best-corrected visual acuity (BCVA, approximate ETDRS letters) and central macular thickness (CMT, μm), number of visits and IVI, and rates of anti-VEGF switch and intravitreal dexamethasone implant (IDI) combination were evaluated.
Results: The 3, 6, 12, 24, and 36-month cohorts included 1372 (854), 1352 (838), 1185 (722), 972 (581), and 623 (361) eyes (patients), respectively. The mean baseline BCVA and CMT were 51.4±21.4 letters and 482.6±180.3 μm. The mean changes from baseline in BCVA were +7.6, +9.1, +8.0, +8.6, and +8.4 letters, and in CMT were -115.4, -140.0, -147.9, -167.3, and -215.4 μm at the 3, 6, 12, 24, and 36-month visits (p<0.001 for all). The median cumulative number of anti-VEGF IVI was 3.0, 3.0, 5.0, 7.0, and 9.0, respectively. The overall anti-VEGF switch and IDI combination rates were 18.5% (253/1372 eyes) and 35.0% (480/1372 eyes), respectively.
Conclusion: This largest real-life study of DME from Türkiye demonstrated BCVA gains inferior to randomized controlled trials, mainly due to the lower number of IVI. However, with the lower baseline BCVA and higher IDI combination rates in our cohorts, these gains were relatively superior to other real-life study counterparts.
期刊介绍：
The Turkish Journal of Ophthalmology (TJO) is the only scientific periodical publication of the Turkish Ophthalmological Association and has been published since January 1929. In its early years, the journal was published in Turkish and French. Although there were temporary interruptions in the publication of the journal due to various challenges, the Turkish Journal of Ophthalmology has been published continually from 1971 to the present. The target audience includes specialists and physicians in training in ophthalmology in all relevant disciplines.
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