ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1712378
This article is part of the Research TopicNew Concepts, Advances, and Future Trends in Clinical Research on Eye DiseasesView all 71 articles
Simultaneous Bilateral Intravitreal Anti-Vascular Endothelial Growth Factor Injections from One Vial for Diabetic Macular Edema: A Retrospective Analysis
Provisionally accepted
- Zhejiang Hospital, Hangzhou, 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: The objective of this study was to assess the safety and efficacy of simultaneous bilateral intravitreal injections of anti-vascular endothelial growth factors (anti-VEGF) from a single vial for the treatment of diabetic macular edema (DME). Methods: A retrospective case series study was undertaken. The study population comprised patients who underwent intravitreal anti-vascular endothelial growth factor injections for DME at the Ophthalmology department of Zhejiang Hospital between January 2022 and May 2024. Participants were categorized into bilateral (n=34, 102 injections) and unilateral (n=93, 210 injections) groups. The primary outcome measures were best corrected visual acuity (BCVA) and central subfield thickness (CST), cube average thickness (CAT) along with the incidence of severe clinical complications. Statistical analysis was performed using the Mann-Whitney U test and Wilcoxon rank sum test. Results: There were no statistically significant differences in terms of age, gender, hypertension, years of diabetes, disorganization of the inner retinal layers (DRIL), ellipsoid zone (EZ) grade, BCVA, CST or CAT at baseline between the two groups. Both bilateral and unilateral injection groups demonstrated significant enhancements in BCVA at 1 month post-injection (P<0.001; P<0.001). A substantial decrease in CST and CAT were observed in both groups at 1 month post-injection (P<0.001; P<0.001; P<0.000; P<0.000). The median improvement in BCVA at 1 month post-injection relative to pre-injection was 8.0 letters (IQR: 3.0 to 19.0) in the bilateral injection group and 5.5 letters (IQR: 1.0 to13.0) in the unilateral injection group, with a statistically significant difference between the two groups (P=0.009). The reduction in CAT demonstrated significant difference between the two groups (P<0.001). No severe complications, including cataract, retinal detachment, choroidal detachment, vitreous hemorrhage, or endophthalmitis, were reported in any of the patients. Conclusion: Simultaneous bilateral anti-VEGF injections from a single vial are both safe and efficacious for the treatment of DME, thereby reducing the treatment burden, visit times and costs while enhancing patient compliance.
Keywords: Intravitreal injection, diabetic macular edema, Anti-Vascular Endothelial Growth Factors, Safety, efficacy
Received: 24 Sep 2025; Accepted: 14 Oct 2025.
Copyright: © 2025 Dai, Lou, Wen, Liang, Xu and Wang. 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: Juanjuan Wang, w17858832502@163.com
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.