September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Management of diabetic macular edema with visual impairment in real-life practice in France: findings from the cross-sectional BOREAL DME study
Author Affiliations & Notes
  • Catherine P Garcher
    Ophtalmology, CHU Dijon, Dijon, France
  • Pascale G Massin
    Ophtalmology, Hôpital Lariboisiére, Paris, France
  • Frank Fajnkuchen
    Centre Imagerie et Laser, Paris, France
  • Agnes Glacet-Bernard
    Centre Hospitalier Intercommunal de Créteil, Créteil, France
  • Laurent Kodjikian
    Hospices Civils de Lyon, Lyon, France
  • Jean-François Maher GIRMENS
    Hôpital des Quinze-Vingt, Paris, France
  • Cécile Delcourt
    ISPEP, Bordeaux, France
  • Pierre-Jean Guillausseau
    Hôpital Lariboisiére, Paris, France
  • Anne Ponthieux
    Retine, Novartis Pharma SAS, Rueil-Malmaison, France
  • Footnotes
    Commercial Relationships   Catherine Garcher, Alcon (C), Alimera (C), Allergan (C), Baudch and Lomb (C), Bayer (C), Horus (C), Novartis (C), Thea (C), Zeiss (C); Pascale Massin, Allergan (C), Bayer (C), Novartis (C); Frank Fajnkuchen, Novartis (C); Agnes Glacet-Bernard, Allergan (C), Bayer (C), Novartis (C); Laurent Kodjikian, Novartis (C); Jean-François GIRMENS, Allergan (C), Bayer (C), Novartis (C); Cécile Delcourt, Novartis (C); Pierre-Jean Guillausseau, Novartis (C); Anne Ponthieux, Novartis (E)
  • Footnotes
    Support  Novartis Pharma SAS
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2086. doi:
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      Catherine P Garcher, Pascale G Massin, Frank Fajnkuchen, Agnes Glacet-Bernard, Laurent Kodjikian, Jean-François Maher GIRMENS, Cécile Delcourt, Pierre-Jean Guillausseau, Anne Ponthieux; Management of diabetic macular edema with visual impairment in real-life practice in France: findings from the cross-sectional BOREAL DME study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2086.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Diabetic macular edema (DME) is the leading cause of visual impairment (VI) in patients with diabetes. With the introduction of anti-vascular endothelial growth factor (anti-VEGF) agents, management of DME has evolved. The aim of this study was to identify the routine practice for the management of patients with VI due to DME (best-corrected visual acuity [BCVA] ≤20/40) in France in 2014.

Methods : The cross-sectional, observational BOREAL DME study was conducted in a real-life practice in France on request of health authority. The study included patients with Type 1 or 2 diabetes aged ≥18 years who had a reduction in BCVA due to DME (≤20/40) irrespective of treatment prescribed at inclusion (including monitoring alone). The following medical data were collected from patients’ medical files: general patient characteristics, disease characteristics (including diabetes and DME), previous treatment for VI due to DME, and treatment prescribed at inclusion.

Results : Of the 1023 screened patients, 918 were included in the study (Figure 1). The mean age of the patients was 67.0 years with an average 18.9 years of diabetes; 53.1% were male and 67.3% had bilateral DME (Table 1). For this analysis we included 1321 eyes with VI due to DME (BCVA ≤20/40; Figure 1). The majority of eyes (64.6%) had received prior treatment for reduction in BCVA due to DME. In the analyzed eyes, anti-VEGF (49.6%) was the most frequently prescribed treatment at inclusion followed by monitoring alone (41.1%). 65.9% of eyes with monitoring alone had received prior treatment. Corticosteroids were prescribed for 6.5% of eyes, while only 2.2% of eyes received laser. The mean BCVA and central retinal thickness were 53.5 letters and 415 µm, respectively. Overall, 57.8% of eyes presented non-proliferative DR. In the treatment naïve eyes (n=459), 50.5% received ranibizumab, 40.5% had monitoring alone, and 3.9% each received laser and corticosteroids, respectively.

Conclusions : The BOREAL DME study findings suggest that, in real-life practice in France, anti-VEGFs, primarily ranibizumab 0.5 mg, are the primary treatment for VI due to DME, followed by monitoring alone in 2014. Macular laser is currently rarely used in the French population.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Figure 1: Patient Disposition

Figure 1: Patient Disposition

 

Disease characteristics and prior ocular treatment history of evaluable patients and eligible eyes

Disease characteristics and prior ocular treatment history of evaluable patients and eligible eyes

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