Clinical preferences and trends of anti‐vascular endothelial growth factor treatments for diabetic macular edema in Japan

• DOI: 10.1111/jdi.12929
• Publication Date: 2018-09-11T19:41:27Z
• Authors: Masahiko Sugimoto; Hideyuki Tsukitome; Fumiki Okamoto; Tetsuro Oshika; Tetsuo Ueda; Masanori Niki; Yoshinori Mitamura; Hiroto Ishikawa; Fumi Gomi; Shigehiko Kitano; Hidetaka Noma; Masahiko Shimura; Shozo Sonoda; Osamu Sawada; Masahito Ohji; Kozo Harimoto; Masaru Takeuchi; Yoshihiro Takamura; Mineo Kondo; Taiji Sakamoto
• Keywords: Vascular Endothelial Growth Factor A; Recombinant Fusion Proteins; Angiogenesis Inhibitors; Diseases of the endocrine glands. Clinical endocrinology; Macular Edema; 03 medical and health sciences; 0302 clinical medicine; Diabetic macular edema; Ranibizumab; Humans; Practice Patterns, Physicians'; Diabetic Retinopathy; Ophthalmologists; Disease Management; Articles; RC648-665; Prognosis; 3. Good health; Cross-Sectional Studies; Receptors, Vascular Endothelial Growth Factor; Intravitreal Injections; Clinical Competence; Vascular endothelial growth factor; Clinical practice pattern; Follow-Up Studies

AbstractAims/IntroductionTo determine the current clinical preferences of anti‐vascular endothelial growth factor (VEGF) treatment protocols for diabetic macular edema (DME) in Japan.Materials and MethodsThis was a descriptive cross‐sectional study. Answers to a questionnaire consisting of 16 questions were obtained from 176 of 278 (63.3%) surveyed ophthalmologists.ResultsThe results showed that 81.2% preferred intravitreal injections of anti‐VEGF antibodies as the first‐line therapy. The most important indicators for beginning anti‐VEGF therapy were: the best‐corrected visual acuity in 44.3% and the retinal thickness in 30.7%. In the loading phase, 53.4% preferred a single injection, and in the maintenance phase, 75.0% preferred the pro re nata regimen. Financial limitation (85.8%) was reported as the most important difficulty in the treatment. For combination therapy with anti‐VEGF treatment, panretinal photocoagulation, focal photocoagulations and a sub‐Tenon steroid injection were preferred. The contraindications for anti‐VEGF therapy were: prior cerebral infarction (72.7%). Regarding the use of both approved anti‐VEGF agents in Japan, ranibizumab and aflibercept, 39.8% doctors used them appropriately.ConclusionsOur results present the current clinical preferences of anti‐VEGF treatment for DME in Japan. The best‐corrected visual acuity and the retinal thickness are important indicators to institute this therapy. The majority of the ophthalmologists use anti‐VEGF treatment as first‐line therapy and prefer the 1 + pro re nata regimen.