Management of Polypoidal choroidal vasculopathy and diabetic retinopathy: Practice patterns amongst vitreoretinal surgeons of India-A VRSI survey

印度玻璃体视网膜外科医生对息肉状脉络膜血管病变和糖尿病视网膜病变的诊疗模式——一项VRSI调查

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Abstract

PURPOSE: To present results from the Vitreo Retina Society-India (VRSI) 2024 Preference and Trends Survey, focusing on polypoidal choroidal vasculopathy (PCV) and diabetic retinopathy (DR) management practices among Indian vitreoretinal surgeons. METHODS: Responses to a 62-item questionnaire, distributed to all VRSI members over email via Google Forms, were collected over 6 weeks in July--August 2024. Data were analyzed using descriptive statistics. RESULTS: A total of 289 members participated in the survey. The majority of respondents preferred multimodal imaging for the diagnosis of PCV (44.68%) and aflibercept for initiation of therapy (63.12%). Respondents preferred a loading dose with a pro-re-nata regimen (46.45%) and a switch after three injections in cases of suboptimal response (57.45%), with a strong preference for switching to brolucizumab (63.93%). Pan-retinal photocoagulation was the predominantly preferred treatment modality for all cases of proliferative DR, with an increased preference for combining it with antivascular endothelial growth factor (anti-VEGF) in cases with high-risk characteristics. For centre-involving diabetic macular edema, ranibizumab biosimilars (40.79%) in a by pro re nata regimen (53.21%) were preferred. Respondents would switch to steroids (54.48%) for suboptimal response after three anti-VEGF injections (91.04%). CONCLUSIONS: The current preferences in the management of PCV and DR among Indian vitreoretinal surgeons are reported here. The results of this survey will assist fellow practitioners in understanding contemporary real-world practices in relation to established literature and in developing appropriate guidelines.

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