Compliance and Adherence of Patients With Diabetic Macular Edema to Intravitreal Anti–vascular Endothelial Growth Factor Therapy in Daily Practice

Abstract

There are significant differences between patients with AMD and DME regarding compliance and adherence, which also affects outcome. Strategies to tie patients with DME to costly intravitreal therapy need to be developed to improve outcomes and efficacy.

Outcomes of Eyes Lost to Follow-up with Proliferative Diabetic Retinopathy That Received Panretinal Photocoagulation versus Intravitreal Anti–Vascular Endothelial Growth Factor

“…9 Furthermore, more than 40% of patients with DME are lost to follow-up for over 100 days since their last missed appointment. 10 This is particularly worrisome because the effects of being LTFU on eyes with PDR have yet to be explored sufficiently, let alone compared between the 2 available treatments. Our results indicate significantly worse outcomes in eyes receiving anti-VEGF treatment that are LTFU compared with those treated with PRP.…”

“…However, one study has shown that eyes with DME and a single delayed followup of more than 100 days demonstrate no change in median ETDRS letters. 10 Outcomes secondary to macular edema often vary, with some eyes demonstrating no change over long-term follow-up, whereas other eyes demonstrate pronounced VA impairment on presentation. 16 This could be the result of variation in the distortion of the individual retinal layers secondary to the edema.…”

Treatment compliance and adherence among patients with diabetic retinopathy and age-related macular degeneration treated by anti-vascular endothelial growth factor under universal health coverage

“…In fact, comorbid conditions also increase with age [17], and patients with DR and AMD reportedly have at least one comorbidity, with five or more comorbidities in the majority of cases [18]. Another study [19] reported that the presence of other illnesses was the most common cause for the lack of treatment of patients with AMD or DME. Comorbidities can severely limit the patient's ability to operate independently.…”

Diabetic Retinopathy and Blindness: An Epidemiological Overview

“…In a study of European DME patients, 46% had at least one break-off in their anti-VEGF treatment for more than 100 days, and the most common reason for poor compliance was comorbidity. In 60% of these cases, the visual acuity deteriorated significantly after the break [84]. Prevention of vision loss from diabetic macular edema is achievable with the current therapeutic modalities; however it requires very early identification at stages with relatively high visual acuity and needs the introduction of best-corrected visual acuity and OCT in the screening protocol.…”