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Invited Commentary
January 24, 2019

Baseline Predictive Factors in Diabetic Macular Edema Treated With Anti–Vascular Endothelial Growth Factor Therapy

Author Affiliations
  • 1National Institute for Health Research Moorfields Biomedical Research Centre and University College London Institute of Ophthalmology, London, England
JAMA Ophthalmol. 2019;137(4):390. doi:10.1001/jamaophthalmol.2018.6810

In this issue of JAMA Ophthalmology, Bressler et al1 report baseline factors that are associated with the final visual acuity and central subfield thickness at 2 years in patients with visual impairment due to center-involving diabetic macular edema that was treated with any of the 3 anti–vascular endothelial growth factor (VEGF) agents in Protocol T. Although many authors have reported predictive baseline factors based on analyses conducted on other randomized clinical trials and real-world study cohorts of similar patient groups,2-4 this detailed post hoc exploratory analysis of Protocol T highlights a few points that, to my knowledge, have not been previously reported. First, this analysis of Protocol T allowed the study of interactions between the predictive baseline factors and the anti-VEGF administered. The study results showed that there were no interactions between the specific anti-VEGF therapy assigned and the observed predictive baseline factors for both the final visual acuity and central subfield thickness. Therefore, in routine practice, one could apply these baseline predictive factors on any patient irrespective of the choice of anti-VEGF agent planned for that individual.

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