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

BMC Ophthalmol. 2022 Feb 28;22(1):94. doi: 10.1186/s12886-022-02325-x.

Abstract

Objectives: 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.

Methods: 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.

Results: 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).

Conclusion: Insulin therapy does not alter treatment outcomes for anti-VEGF therapy in DME.

Keywords: Anti-VEGF; Central macular thickness; Diabetic macular edema; Insulin; Visual acuity.

Publication types

  • Multicenter Study

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / drug therapy
  • Humans
  • Insulin / therapeutic use
  • Intravitreal Injections
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Insulin