The Injection Practice Patterns of Retina Specialists in Managing Exudative Age-Related Macular Degeneration: A Retrospective Study

Figures & data

Table 1 Patient Demographics and Medical History. Data are Presented as Mean (SD) for Continuous Data and N (%) for Categorical Data

Characteristics	Category	Value (%)
Age		80.3 (9.8)
Sex	Female	91 (66.42)
	Male	46 (33.58)
Race	American Indian/Alaskan Native	1 (0.73)
	Asian	2 (1.46)
	Black/African American	7 (5.11)
	Caucasian/White	127 (92.7)
Smoking		50 (36.03)
Chronic Kidney Disease		27 (19.71)
Hyperlipidemia		73 (53.28)
Hypertensive Retinopathy		16 (11.68)
Glaucoma		41 (29.93)

Table 2 Anti-VEGF Drug Use Among Retina Specialists

	Specialist A N =12	Specialist B N = 37	Specialist C N =70	Specialist D N=53	p-value
Monotherapy (1 anti-VEGF)	8 (66.7)	29 (78.4)	47 (67.1)	46 (86.8)	0.07
Multitherapy (2 or 3 anti-VEGFs)	4 (33.3)	8 (21.6)	23 (32.9)	7 (13.2)
Bevacizumab	12 (100)	29 (78.4)	57 (81.4)	35 (66.0)	0.045*
Aflibercept	4 (33.3)	13 (35.1)	29 (41.4)	24 (45.3)	0.75
Ranibizumab	0	5 (13.5)	9 (12.9)	1 (1.9)	0.08

Note: Data are presented as N (%); *For p < 0.05; N – number of treated eyes.

Table 3 Anti-VEGF Injection Practice Pattern of Retina Specialists, Expressed in Mean Number of Injections per Eye, Mean Time Interval Between Injections, and Total Treatment Duration

	Specialist A (N = 12)	Specialist B (N = 37)	Specialist C (N = 70)	Specialist D (N = 53)	Overall Average	p-value
Mean number of injections per eye	6.9 (1.2)	8.3 (1.2)	15.1 (1.4)	5.6 (0.52)	8.975	0.0001^‡
Mean interval between injections (weeks)	3.8 (0.22)	4.4 (0.41)	6.6 (0.39)	5.5 (0.47)	5.075	0.001^†
Time from first to last injection per eye (weeks)	28.4 (5.77)	42.3 (6.5)	104.9 (9.19)	37.7 (5.19)	53.325	0.0001^‡
Mean logMAR best corrected visual acuity at first treatment	0.85 (0.21)	1.11 (0.1)	0.94 (0.09)	0.78 (0.08)	0.92	0.167
Mean change in logMAR best corrected visual acuity from first to last injection	−0.05 (0.03)	−0.22 (0.09)	0.07 (0.07)	0.06 (0.06)	−0.035	0.031*
Mean OCT thickness at first measurement	306 (25.3)	302 (15.8)	362 (23.3)	302 (26.5)	318	0.177
Mean change in OCT thickness from first to last injection	−53.3 (37.5)	−41.4 (18.5)	−72.7 (18.9)	−21.9 (28.6)	−47.325	0.409

Note: Data are presented as mean (SD), *For p < 0.05, ^†For p < 0.01, ^‡For p < 0.001.

Table 4 Factors Associated with Change in Best Corrected Visual Acuity Using Multivariate Analysis of Covariance

Variable	Category	Estimate	p-value
Best corrected visual acuity at first visit		−0.401	<0.001^†
Specialist	A	0.093	0.57
	B	Ref	Ref
	C	0.257	0.01*
	D	0.240	0.02
Age		0.010	0.02*
Sex	Female	0.135	0.08
	Male	Ref	Ref
Race	White	Ref	Ref
	Other	−0.006	0.97
Smoking	Yes	Ref	Ref
	No	−0.023	0.76
Injection number		0.002	0.85
Interval between injections		−0.003	0.22
Time from first to last injection		0.000	0.70

Note: *For p < 0.05, ^†For p < 0.001.

Table 5 Factors Associated with Change in Central Macular Thickness Over Course of Treatment Using Multivariate Analysis of Covariance

Variable	Category	Estimate	p-value
CMT at first visit		−0.660	<0.001^†
Specialist	A	−0.416	0.99
	B	ref	ref
	C	13.963	0.57
	D	14.630	0.55
Age		0.205	0.83
Sex	Female	48.873	0.01*
	Male	ref	ref
Race	Other	−25.342	0.46
	White	ref	ref
Smoking	No	31.549	0.10
	Yes	ref	Ref
Injection number		2.147	0.53
Interval between injections		0.200	0.78
Time from first to last injection		−0.068	0.44

Note: *For p < 0.05, ^†For p < 0.001, Central Macular Thickness (CMT).