ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicPrevention and Treatment Advancements in Diabetic Retinopathy, volume IIView all articles
Delayed anti–vascular endothelial growth factor therapy in patients with type 2 diabetes mellitus and branch retinal vein occlusion–associated macular edema negatively affects visual outcomes
Provisionally accepted
- Xinjiang 474 Hospital, Urumqi, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To investigate the effect of delayed treatment on six-month visual outcomes in patients with type 2 diabetes mellitus (T2DM) complicated by branch retinal vein occlusion-associated macular edema (BRVO-ME). Methods: This single-center retrospective cohort study included 148 patients diagnosed with BRVO-ME and receiving their first intravitreal ranibizumab injection between January 2024 and May 2025. Patients were stratified according to the interval from diagnosis to initial anti-vascular endothelial growth factor (VEGF) injection into early treatment (≤7 days, n = 67), intermediate treatment (8–14 days, n = 52), and delayed treatment (>14 days, n = 29) groups. Baseline demographic, systemic, and ophthalmic parameters were collected. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) (μm) were recorded at 1, 3, and 6 months post-injection. Multivariable linear regression was used to identify independent factors affecting six-month BCVA improvement. Results: All groups exhibited BCVA improvement and CMT reduction at six months, with the early treatment group showing the greatest improvement. Multivariable regression identified delayed treatment as the only independent factor associated with six-month BCVA improvement (β = −0.008, 95% CI: −0.014 to −0.002, P = 0.010). ROC analysis showed an AUC of 0.823 (95% CI: 0.751–0.884, P < 0.001) for delayed treatment predicting insufficient six-month visual improvement, with a sensitivity of 89.4% and specificity of 61.4% using a 14-day cutoff. Conclusions: Initiation of anti-VEGF therapy within seven days of diagnosis is associated with greater six-month visual improvement in patients with BRVO-ME and T2DM. Delayed treatment may contribute to suboptimal visual recovery.
Keywords: anti–vascular endothelial growth factor, Branch retinal vein occlusion, Delayed treatment, Macular Edema, Ranibizumab, Visual improvement
Received: 22 Sep 2025; Accepted: 12 Feb 2026.
Copyright: © 2026 Deng, Liu, Li, Song and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoling Zhang
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.