Clinical Scorecard: Refractive Error Management During Anti-VEGF Therapy
At a Glance
| Category | Detail |
|---|---|
| Condition | Diabetic Macular Edema (DME) and Neovascular Age-Related Macular Degeneration (nAMD) |
| Key Mechanisms | Anti-VEGF injections targeting macular edema and subretinal fluid |
| Target Population | Patients with DME and nAMD undergoing anti-VEGF therapy |
| Care Setting | Ophthalmology clinics |
Key Highlights
- Refractive errors are often inadequately addressed in patients undergoing anti-VEGF treatment.
- Small hyperopic shifts observed during anti-VEGF therapy may warrant updated refractions.
- Delaying refractive correction could be counterproductive for maximizing visual function.
- Robust studies are needed to inform clinical guidelines on refractive error management.
- Most physicians currently recommend holding refraction during anti-VEGF treatments.
Guideline-Based Recommendations
Diagnosis
- Consider regular assessments of refractive error in patients undergoing anti-VEGF therapy.
Management
- Offer updated refractions to patients with DME undergoing anti-VEGF treatment, even with persistent macular edema.
Monitoring & Follow-up
- Monitor visual acuity and refractive error changes over time during anti-VEGF therapy.
Risks
- Inaccurate refractions may lead to suboptimal spectacle correction and visual outcomes.
Patient & Prescribing Data
Patients with DME and nAMD receiving anti-VEGF injections.
Refractive shifts during treatment are generally small and may not significantly impact visual acuity.
Clinical Best Practices
- Regularly update refractions to optimize visual outcomes in patients undergoing anti-VEGF therapy.
- Consider the impact of retinal changes on refractive measurements.
References
- Salabati et al. study on refractive error changes
- Comparison of Age-Related Macular Degeneration Treatment Trials (CATT)
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