Systemic Anemia and the Risk of Diabetic Macular Edema and Anti-VEGF Injections

PURPOSE: To investigate a severity gradient between anemia and the 1-year risk of developing diabetic macular edema (DME) and the need for anti-VEGF injections in patients with type 2 diabetes mellitus (T2DM). DESIGN: Multicenter retrospective cohort study. PARTICIPANTS: Patients with newly recorded T2DM and no prior diabetic eye disease in the TriNetX US Collaborative Network, with a documented ambulatory encounter in the 12 months preceding the index T2DM diagnosis, were included. Exclusions included hemolytic and aplastic anemias, bone marrow failure syndromes, and retinal vascular occlusions. METHODS: Patients were stratified by hemoglobin level into combined and sex-specific cohorts. A sensitivity analysis evaluated patients with a hemoglobin level of