BACKGROUND AND OBJECTIVE: Prior investigation shows retina specialists may select different treatment for age-related macular degeneration for themselves than for a hypothetical patient. The authors sought to investigate whether a similar bias exists for treatment decisions by retina specialists with regard to diabetic macular edema (DME). PATIENTS AND METHODS: Two surveys asked retina specialists to select treatment for hypothetical patients with DME or for themselves. In Survey 2, a distinction was drawn between a visual acuity (VA) of 20/40 or better and 20/50 or worse. RESULTS: In Survey 1, 54% to 61% of respondents selected bevacizumab (Avastin; Genentech, South San Francisco, CA) for patients and 36% to 40% selected the drug for themselves (P < .0004). It was found that 14% to 17% selected aflibercept (Eylea; Regeneron, Tarrytown, NY) for patients versus 31% to 38% who selected it for themselves (P < .0001). For a VA of 20/40 or better, 42% to 50% selected bevacizumab for their patients versus 32% to 39% (P < .0005) for themselves, and 20% to 23% selected aflibercept for patients versus 39% to 48% (P < .0007) for themselves. For a VA of 20/50 or worse, 24% to 28% chose bevacizumab for patients versus 17% to 20% for themselves (P value was not significant), and 59% to 66% selected aflibercept for their patients versus 66% to 78% for themselves (P < .05). CONCLUSION: Physicians recommend different treatment for their patients than for themselves, though not for a VA of 20/50 or worse, where data support the use of aflibercept over bevacizumab. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:544-554.]. Copyright 2016, SLACK Incorporated.
BACKGROUND AND OBJECTIVE: Prior investigation shows retina specialists may select different treatment for age-related macular degeneration for themselves than for a hypothetical patient. The authors sought to investigate whether a similar bias exists for treatment decisions by retina specialists with regard to diabetic macular edema (DME). PATIENTS AND METHODS: Two surveys asked retina specialists to select treatment for hypothetical patients with DME or for themselves. In Survey 2, a distinction was drawn between a visual acuity (VA) of 20/40 or better and 20/50 or worse. RESULTS: In Survey 1, 54% to 61% of respondents selected bevacizumab (Avastin; Genentech, South San Francisco, CA) for patients and 36% to 40% selected the drug for themselves (P < .0004). It was found that 14% to 17% selected aflibercept (Eylea; Regeneron, Tarrytown, NY) for patients versus 31% to 38% who selected it for themselves (P < .0001). For a VA of 20/40 or better, 42% to 50% selected bevacizumab for their patients versus 32% to 39% (P < .0005) for themselves, and 20% to 23% selected aflibercept for patients versus 39% to 48% (P < .0007) for themselves. For a VA of 20/50 or worse, 24% to 28% chose bevacizumab for patients versus 17% to 20% for themselves (P value was not significant), and 59% to 66% selected aflibercept for their patients versus 66% to 78% for themselves (P < .05). CONCLUSION: Physicians recommend different treatment for their patients than for themselves, though not for a VA of 20/50 or worse, where data support the use of aflibercept over bevacizumab. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:544-554.]. Copyright 2016, SLACK Incorporated.