Clinical Report: Refractive Error Management During Anti-VEGF Therapy
Overview
This report highlights the importance of addressing refractive errors in patients undergoing anti-VEGF therapy for diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD). Despite the small refractive shifts observed during treatment, timely updates to refractions may enhance visual outcomes.
Background
Diabetic retinopathy and age-related macular degeneration are leading causes of vision loss in different age groups. Anti-VEGF injections are the primary treatment for both conditions, yet refractive errors are often overlooked in clinical management. Addressing these errors is crucial for optimizing visual acuity and overall patient outcomes.
Data Highlights
| Study | Mean Spherical Shift (SE) | Mean Spherical Shift (FE) |
|---|---|---|
| Salabati et al. | ~0.10 D | ~0.15 D |
Key Findings
- Refractive shifts during anti-VEGF therapy are generally small but statistically significant.
- The mean spherical shift in the study eye was approximately 0.10 D, and in the fellow eye, it was about 0.15 D.
- Shifts of >0.50 D are typically required to impact visual acuity significantly.
- Delaying refractive updates may be counterproductive in maximizing visual function.
- Pseudophakic patients with edema showed a statistically significant refractive shift.
Clinical Implications
Clinicians should consider regular updates to refractions in patients receiving anti-VEGF therapy to ensure optimal spectacle correction. This approach may help mitigate the impact of refractive errors on visual acuity, particularly as retinal edema resolves.
Conclusion
Addressing refractive errors during anti-VEGF therapy is essential for maximizing visual outcomes in patients with DME and nAMD. Ongoing research is needed to refine clinical guidelines regarding refractive management in this population.
References
- Salabati et al., Retinal Physician, 2025 -- Refractive Error Management During Anti-VEGF Therapy
- Diabetic Retinopathy Preferred Practice Pattern® - PubMed
- Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema - PubMed
- Management of Macular Edema in RVO, Retinal Physician, 2015
- Anti-VEGF Therapies and Retinal Disease, Optometric Management, 2010
- Contact Lens Spectrum — Treatment Plan
- Optometric Management — VEGF inhibitors: Changing the landscape of retina care
- Diabetic Retinopathy Preferred Practice Pattern® - PubMed
- Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema - PubMed
- Refractive Error Management During Anti-VEGF Therapy | Retinal Physician
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