Poor Avastin responders in AMD & DME may have increased risk to obstructive sleep apnea

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Poor responders to Bevacizumab (Avastin) in patients with age-related macular degeneration (AMD) and diabetic macular edema (DME) may have increased risk to obstructive sleep apnea (OSA).







In this study, age-related macular degeneration group was categorized into nonexudative, exudative, or poor response exudative, while the diabetic macular edema group included patients with nonproliferative diabetic retinopathy and cystoid macular edema. Patients were categorized based on the number of intravitreal injections of bevacizumab received. Both groups were compared with age-matched controls. Patients completed a screening questionnaire to assess the risk for OSA, the main outcome measure.

Of 103 patients with AMD, 56 (54.37%) had nonexudative AMD and 47 (45.63%) had exudative AMD, of which 14 (29.79%) had poor response exudative AMD and were at a significantly higher risk of OSA (P < 0.05). Of 30 diabetic macular edema patients with cystoid macular edema, 4 (19%) received 1 injection, 18 (81.82%) received 2 or more consecutive injections, and 16 (72.73%) received 3 or more consecutive injections. Risk for OSA increased significantly with increasing number of injections.

According to the authors, patients with exudative AMD and diabetic macular edema with poor response to anti-vascular endothelial growth factor therapy have a significantly higher risk of OSA compared with age-matched controls and hence should be screened to assess the risk of OSA.

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