Étude des pratiques françaises dans la prise en charge de l’œdème maculaire diabétique

Qu-Knafo, L.; Fajnkuchen, Franck; Sarda, V.; Nghiem-Buffet, Sylvia; Chaîne, G.; Giocanti-Aurégan, Audrey

doi:10.1016/j.jfo.2016.02.005

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…In the French study, most specialists reported initiating DME treatment when visual acuity is >0.5 (Monoyer scale). 28…”

Section: Discussionmentioning

confidence: 99%

“…Intravitreal implants have been introduced recently, but studies conducted to assess the effectiveness of steroids have reported mixed results. 10 Although there is evidence to support the use of intravitreal steroids in DME, 28,37 there is no clear consensus about whether these should be used as first-line therapy or for refractory cases. Despite their high rates of adverse effects, steroids may also be considered for patients who do not adequately respond to anti-VEGFs, as noted in the European licensing approval for fluocinolone, which states that this drug should be used only when other therapies have not had sufficient effect.…”

Section: Discussionmentioning

confidence: 99%

“…[25][26][27] The most commonly used anti-VEGF agent reported by the specialists in this survey was ranibizumab (75.9% of respondents), followed by aflibercept (12.4%) and bevacizumab (10.9%), a finding that is in line with results of a study performed to assess patterns of care in France for the treatment of DME. 28 In that study, for center-involved DME in phakic or pseudophakic eyes, the first choice of intravitreal treatment was ranibizumab. The predominance of ranibizumab use may be due to the fact that it received marketing authorization by the European Medicines Agency (EMA) in the year 2010 for DME, 29 4 years later aflibercept was approved (in 2014).…”

Section: Treatmentmentioning

confidence: 99%

“…In the French study, most specialists reported initiating DME treatment when visual acuity is >0.5 (Monoyer scale). 28 Regardless of the treatment indication, there are essentially two regimens for administering anti-VEGF drugs: continuous and intermittent/as required (or pro re nata (PRN)). Most of the initial trials were conducted using the continuous regimen, with regular monthly injections administered over the course of 2 years (24 injections in total).…”

Section: Treatmentmentioning

confidence: 99%

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Management of diabetic macular edema patients in clinical practice in Spain

Abreu-González¹,

Gallego-Pinazo

Abraldes

et al. 2018

European Journal of Ophthalmology

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Purpose: Diabetic macular edema is the main cause of blindness in diabetic patients. Vascular endothelial growth factor is involved in diabetic macular edema pathogenesis. Vascular endothelial growth factor inhibitors are an important option in diabetic macular edema therapy. This survey investigates actual clinical practice in diabetic macular edema in Spain. Methods: An expert advisory panel of 17 Spanish ophthalmologists developed a 30-item anonymous questionnaire about diagnosis, treatment, and follow-up in diabetic macular edema. A total of 137 ophthalmologists from 10 Spanish regions completed the questionnaire online. Results: Almost all of the respondents (99.3%) record the measured visual acuity and perform biomicroscopic anterior (94.9%) and posterior (91.2%) segment examinations. Similarly, 100% of responding ophthalmologists always/almost always or frequently perform optical coherence tomography. Most respondents (65%) always/almost always or frequently perform a retinography. More than 50% rarely perform fluorescein angiography. Nearly, all (96.4%) of the specialists responded that, in center-involved diabetic macular edema, the first treatment is an anti–vascular endothelial growth factor drug. For corticosteroids, the first choice of most respondents (91.2%) was the dexamethasone implant. In the follow-up, almost all (96.4%) specialists record the measured visual acuity and most also perform biomicroscopic anterior (82.5%) and posterior (83.2%) segment examination. Conclusion: This survey shows the actual clinical practice in diabetic macular edema in Spain, finding that anti–vascular endothelial growth factor therapy is frequently used, and that diagnosis, treatments, and follow-up examinations used by specialists are homogeneous and according to diabetic macular edema guidelines.

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“…In the French study, most specialists reported initiating DME treatment when visual acuity is >0.5 (Monoyer scale). 28…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Management of diabetic macular edema patients in clinical practice in Spain

Abreu-González¹,

Gallego-Pinazo

Abraldes

et al. 2018

European Journal of Ophthalmology

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“…Comparative analyses were only performed for the 2013-2018 study period since anti-VEGF agents and corticosteroids were marginally prescribed in France before 2013. Therefore, patients treated before 2013 may not be representative of the population we aimed to study [8,10,39,40].…”

Section: Main Outcomesmentioning

confidence: 99%

Association between Obstetric Complications and Intravitreal Anti-Vascular Endothelial Growth Factor Agents or Intravitreal Corticosteroids

Ghezala

Mariet

Benzenine

et al. 2022

JPM

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This nationwide population-based cohort study aimed to describe the use of intravitreal injections (IVTs) of anti-vascular endothelial growth factor (anti-VEGF) agents and corticosteroids in pregnant women in France and to report on the incidence of obstetric and neonatal complications. All pregnant women in France who received any anti-VEGF or corticosteroid IVT during pregnancy or in the month preceding pregnancy from 1 January 2009 to 31 December 2018 were identified in the national medico-administrative databases. Between 2009 and 2018, there were 5,672,921 IVTs performed in France. Among these IVTs, 228 anti-VEGF or corticosteroid IVTs were administered to 139 women during their pregnancy or in the month preceding their pregnancy. Spontaneous abortion or the medical termination of pregnancy occurred in 10 women (16.1%) who received anti-VEGF agents and in one (3.1%) of the women who received corticosteroids (p = 0.09). This is the first national cohort study of pregnant women treated with anti-VEGF or corticosteroid IVTs. We found a high incidence of obstetric complications in pregnant women treated with anti-VEGF or corticosteroid IVTs but could not demonstrate a statistically significant association between the intravitreal agents and these complications. These agents should continue to be used with great caution in pregnant women.

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