Real-World Data on Treatment Compliance and Visual Outcomes Between Patients With Diabetic Macular Edema or Retinal Vein Occlusion Receiving Antivascular Endothelial Growth Factor Injections or Intravitreal Corticosteroid Implants

Abstract

Purpose: To evaluate real-world differences in treatment frequency, appointment compliance, and visual outcomes among patients with DME or RVO whose eyes either remained on antivascular endothelial growth factor (anti-VEGF) therapy or were transitioned to slow-release intravitreal corticosteroid implants. Methods: This retrospective cohort study used electronic health records data (2012–2024) from the Cole Eye Institute to identify patients ages ≥18 years diagnosed as having DME or RVO, with included eyes divided into 2 groups: a study group receiving 6 months of anti-VEGF injections followed by 12 months of intravitreal corticosteroid implants, and a control group receiving anti-VEGF injections for the entire 18-month period. Descriptive analysis compared appointment burden and compliance, best-corrected visual acuity (BCVA), and central subfield thickness (CST) between the overall cohort, DME eyes, and RVO eyes. Results: Ninety-nine eyes (48 study, 51 control) were included. The study group had a higher number of scheduled appointments, despite receiving fewer injections after switching to intravitreal corticosteroid implants. Appointment compliance in the study group remained unchanged before and after switching. Over 18 months, BCVA remained stable, while CST decreased with anti-VEGF therapy but increased after eyes were switched to intravitreal corticosteroid implants. Conclusions: Although injection frequency was reduced in patients with DME or RVO receiving intravitreal corticosteroid implants, this treatment did not improve appointment compliance and was associated with less favorable anatomic outcomes. Nonetheless, intravitreal corticosteroid implants preserved visual function and may represent a viable alternative for patients with refractory disease or compliance barriers.