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THE IMPACT OF THE VITREOMACULAR INTERFACE ON FUNCTIONAL AND ANATOMICAL OUTCOMES IN DIABETIC MACULAR EDEMA TREATED WITH THREE DIFFERENT ANTI-VEGF AGENTS

Our results of post hoc analysis of the DRCR Protocol T trial provides evidence that patients with diabetic macular edema presented with complete or partial vitreomacular adhesion at baseline may derive to better visual results under anti-VEGF treatment, compared with those with complete posterior vitreous detachment. Purpose: To investigate the impact of baseline vitreomacular interface status on treatment outcomes in patients treated with three different anti–vascular endothelial growth factors for diabetic macular edema. Methods: Post hoc analysis from patients enrolled in the DRCR.net Protocol T study. Optical coherence tomography images were analyzed at baseline and at the end of follow-up to identify the presence of complete vitreomacular adhesion, partial vitreomacular adhesion, vitreomacular traction syndrome, and complete posterior vitreous detachment. Results: Six hundred and twenty-nine eyes were eligible for the study based on the study criteria. Complete adhesion eyes gained on average +3.7 more ETDRS letters compared with the complete posterior vitreous detachment group at the end of the 12 months follow-up (P < 0.001). Baseline vitreomacular interface status had no significant influence on central subfield thickness at 12 months (P = 0.144). There was no difference between the treatment arms based on effect of baseline vitreomacular interface status on best-corrected visual acuity gain. Conclusion: This study provides evidence that vitreomacular interface status affects functional outcomes in diabetic macular edema patients treated with anti–vascular endothelial growth factor injections. The presence of complete or partial vitreomacular adhesion at baseline may be associated with a larger treatment benefit than those with complete posterior vitreous detachment.