Anti-VEGF Treatment for DME More Effective in Patients Under 50

Anti-VEGF treatments attack many retinal diseases, including DME. Photo: Jay Haynie, OD. Click image to enlarge. A recent study found that patient age influences how well individuals with diabetic macular edema (DME) respond to anti-VEGF therapy, with younger patients benefitting most and older ones experiencing “greater likelihood of weak treatment response in visual acuity and central subfield thickness” after two years, according to a paper published in Retina.All 1,006 patients in the study were individuals 18 years of age or older who had Type 1 or Type 2 diabetes and “at least one eye meeting the protocol-specific eligibility criteria,” explained the authors in their paper. The data comes from three DRCR Retina Network clinical trials wherein subjects were assigned an anti-VEGF treatment at random. The researchers evaluated outcomes after two years of treatment, classifying patient responses as either strong or weak “based on standard definitions of these categories” that account for baseline visual acuity (VA) or central subfield thickness (CST) status.Patients were categorized into four groups based on their age: under 50 years old, between 50 and 59, between 60 and 69, and 70 or older. They were examined over the span of 104 weeks, with 87% attending every weekly visit. Patient demographics varied, with a majority white (64%) and male (54%) cohort across all groups. A total of 7% had Type 1 diabetes and 91% had Type 2.After conducting the two-year follow-up, the researchers concluded that a weak response occurred in 34% of the under-50 cohort, 46% of the 50-59 group, 49% in the 60-69 group and 53% in the 70+ group. The authors attributed this in part to “duration and control of diabetes,” with older patients in this study having experienced “a longer duration of the disease, better hemoglobin A1c, comparable VA and thinner CST at baseline.” They noted that while all the groups did benefit from the treatment, “the older groups did not demonstrate a similar degree of improvement compared with the younger groups,” potentially because of diabetes duration or “age-related physiological changes in retinal tissues that reduce retinal resiliency and ability to recover from functional deficits.”Because DME is “the leading cause of vision loss in people with diabetes,” it’s vital to monitor visual progression in diabetic patients. In addition, with age as a potential factor in treatment response, it is important to be on the lookout for older patients should an alternative treatment route be necessary to prevent vision loss.Click here for the journal source. Liu D, Maguire M, Jonna G, et al. Association of patient age with response to anti-vascular endothelial growth factor agents for treatment of diabetic macular edema. Retina. February 24, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.