fe0ccb118ff94f3f4a8b69102eaa5c90 jcm-15-04508-v2.pdf a8628ccc1adf0f0dd9108e6d807ef9375b06a329 jcm-15-04508-v2.pdf c20c3aa387e981e05128f30abc52a77c969a77de867d918c46074ac29c32f0c9 jcm-15-04508-v2.pdf Title: Intravitreal Therapy in Adults Aged 50 Years: Etiologic Spectrum, Treatment Patterns and Visual Outcomes in a Real-World Cohort Subject: Background: Intravitreal injections (IVI) are widely used for the management of retinal diseases, yet younger adults are underrepresented in clinical trials and real-world reports. Data on the etiologic distribution and treatment patterns of IVI in patients aged 50 years remain limited. This study aimed to characterize the indications, treatment strategies, and visual outcomes of IVI in this age group. Material and Methods: Retrospective, single-center observational study including adults aged 18–50 years who received IVI between January 2020 and December 2023 at a tertiary referral hospital in Spain. Demographic data, diagnosis, treatment modality, regimen, number of injections and best-corrected visual acuity (BCVA) were collected. One eye per patient was included for analysis. Visual outcomes were assessed as change in logMAR BCVA between baseline and final follow-up. Results: A total of 122 patients were included. The most frequent indications were diabetic macular edema (29.5%), macular neovascularization of various etiologies (21.3%), retinal vein occlusion (13.9%) and uveitis (9.8%). Anti-vascular endothelial growth factor (anti-VEGF) agents were used in 80.3% of eyes, corticosteroids in 6.6% and combination therapy in 13.1%. The mean number of injections per patient was 6.0 5.3 over a mean follow-up of 3.0 2.5 years. Overall BCVA improved significantly from 0.50 0.59 to 0.38 0.50 logMAR (p = 0.012). Conclusions: IVI in adults 50 years is uncommon but encompasses a broad etiologic spectrum. Diabetic macular edema and macular neovascularization of diverse etiologies were the leading indications. Anti-VEGF therapy represented the main treatment modality in this cohort. Keywords: intravitreal injections; young adult; diabetes; macular edema Author: Carmen Antía Rodríguez-Fernández, David Oliver-Gutierrez, Albert Arnaiz, Tatiana Pablos, Gloria Segura-Duch and Miguel Ángel Zapata Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Tue Jun 16 10:36:33 2026 CEST ModDate: Tue Jun 16 10:43:03 2026 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 340020 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- CFZGNH+URWPalladioL-Roma Type 1 Custom yes yes yes 104 0 MKDKUG+URWPalladioL-Ital Type 1 Custom yes yes yes 105 0 MIKRSI+VnURWPalladioL Type 1 Custom yes yes yes 106 0 VDNGGL+CMSY10 Type 1 Builtin yes yes yes 107 0 DEUCGY+URWPalladioL-Bold Type 1 Custom yes yes yes 108 0 TTFQJI+CMBSY10 Type 1 Builtin yes yes yes 109 0 URYLRZ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 178 0 GKIKBC+PalatinoLinotype TrueType WinAnsi yes yes no 166 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-09-05 04:34:57 CEST RepresentationInformation: jcm-15-04508-v2.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-09-04 12:56:36 CEST Size: 340020 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 309 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Study Design and Participants Item: Title: Clinical Assessment and Data Collection Item: Title: Outcome Measures Item: Title: Statistical Analysis Item: Title: Results Children: Item: Title: Etiologic Diagnosis Item: Title: Treatment Pattern Item: Title: Visual Outcomes Item: Title: Safety Item: Title: Discussion Item: Title: Conclusions Item: Title: References Info: Title: Intravitreal Therapy in Adults Aged 50 Years: Etiologic Spectrum, Treatment Patterns and Visual Outcomes in a Real-World Cohort Author: Carmen Antía Rodríguez-Fernández, David Oliver-Gutierrez, Albert Arnaiz, Tatiana Pablos, Gloria Segura-Duch and Miguel Ángel Zapata Subject: Background: Intravitreal injections (IVI) are widely used for the management of retinal diseases, yet younger adults are underrepresented in clinical trials and real-world reports. Data on the etiologic distribution and treatment patterns of IVI in patients aged 50 years remain limited. This study aimed to characterize the indications, treatment strategies, and visual outcomes of IVI in this age group. Material and Methods: Retrospective, single-center observational study including adults aged 18–50 years who received IVI between January 2020 and December 2023 at a tertiary referral hospital in Spain. Demographic data, diagnosis, treatment modality, regimen, number of injections and best-corrected visual acuity (BCVA) were collected. One eye per patient was included for analysis. Visual outcomes were assessed as change in logMAR BCVA between baseline and final follow-up. Results: A total of 122 patients were included. The most frequent indications were diabetic macular edema (29.5%), macular neovascularization of various etiologies (21.3%), retinal vein occlusion (13.9%) and uveitis (9.8%). Anti-vascular endothelial growth factor (anti-VEGF) agents were used in 80.3% of eyes, corticosteroids in 6.6% and combination therapy in 13.1%. The mean number of injections per patient was 6.0 5.3 over a mean follow-up of 3.0 2.5 years. Overall BCVA improved significantly from 0.50 0.59 to 0.38 0.50 logMAR (p = 0.012). Conclusions: IVI in adults 50 years is uncommon but encompasses a broad etiologic spectrum. Diabetic macular edema and macular neovascularization of diverse etiologies were the leading indications. Anti-VEGF therapy represented the main treatment modality in this cohort. 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