Impact of Comorbid Hypertension and Diabetes on Anti‐VEGF Treatment Outcomes in Macular Edema

TL;DR

This study found that patients with both hypertension and diabetes respond less well to anti-VEGF treatment for macular edema compared to those without these conditions.

Contribution

The study identifies hypertension and diabetes as independent negative predictors of anti-VEGF treatment outcomes in macular edema.

Findings

Patients without comorbidities showed the greatest improvement in visual acuity and macular thickness after anti-VEGF treatment.

Hypertension and diabetes were confirmed as independent negative predictors of treatment effectiveness.

Poor control of blood pressure and glucose levels was linked to reduced anatomical improvement.

Abstract

This study evaluated the effects of intravitreal injection of antivascular endothelial growth factor (VEGF) treatment on visual acuity and macular edema severity in patients with comorbid hypertension and diabetes macular edema in China.

A longitudinal observational study, involving a total of 89 cases with macular edema who received anti‐VEGF injection treatment, compared the changes in visual acuity and macular edema severity among four groups of patients at three different time points. Additionally, through regression analysis, it explored the changes in best‐corrected visual acuity (BCVA) and central macular thickness (CMT) in patients with hypertension and diabetes after receiving different numbers of anti‐VEGF treatments, as well as the relationship between the number of injections and visual improvement and edema reduction.

Significant improvements in BCVA and CMT were observed following anti‐VEGF treatment, most notably after the first injection. The group without comorbidities demonstrated the greatest improvements, with BCVA improving from 0.20 to 0.40 logMAR and CMT decreasing from approximately 600 μm to 200 μm. In contrast, patients with hypertension and/or diabetes exhibited attenuated therapeutic responses. Multifactorial regression analysis confirmed that the presence of hypertension and/or diabetes served as an independent negative predictor for both BCVA improvement (β = 0.12, p = 0.002) and CMT reduction (β = −149.8, p < 0.001). Furthermore, poorer control of blood pressure and blood glucose levels was associated with diminished anatomical improvement.

In summary, patients with both hypertension and diabetes face greater challenges in terms of their overall health condition, the rate of vision decline, and the improvement of macular edema. It is recommended to initiate treatment for patients with comorbidities earlier, increase the number of injections, and combine other therapies to enhance the treatment effect.

Taizhou Municipal Hospital: LWYJ2025268

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