September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Retrospective Review of Snellen Visual Acuity in Patients with Diabetic Macular Edema, Prior to Initiation of Anti-VEGF Treatment
Author Affiliations & Notes
  • Sarah Fishbein
    R&D, California Retina Consultants, Santa Barbara, California, United States
  • Nathan Steinle
    R&D, California Retina Consultants, Santa Barbara, California, United States
  • Gina Hong
    R&D, California Retina Consultants, Santa Barbara, California, United States
  • Footnotes
    Commercial Relationships   Sarah Fishbein, None; Nathan Steinle, None; Gina Hong, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2094. doi:
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    • Get Citation

      Sarah Fishbein, Nathan Steinle, Gina Hong; Retrospective Review of Snellen Visual Acuity in Patients with Diabetic Macular Edema, Prior to Initiation of Anti-VEGF Treatment. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2094.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : DRCR.net Protocol T shows that treatment-naive DME patients presenting with ETDRS BCVA ≤20/50 showed better improvement in BCVA when treated with aflibercept compared to those treated with bevacizumab and ranibizumab. The only evidence to date that has stratified visual acuity of treatment naïve DME patients, inclusive of all baseline visual acuities, was in ETDRS Report No. 19, published in 1995. In a real world practice setting, the ratio of treatment-naive patients with DME that present with visual acuity of 20/40 or better to those with 20/50 or worse has not been investigated.

Methods : In a retrospective random sample chart review, we recorded the Snellen Visual Acuity (VA) of patients (n=181) just prior to initial Anti-VEGF treatment for DME. We then calculated the percentage of patients presenting with Snellen VA of 20/50 or worse (n=111) and also the percentage of patients that would have an equivalent BCVA on ETDRS of 20/50 or worse (n = 87) using a published correction factor between Snellen and ETDRS charts.

Results : Patients with Snellen VA of 20/50 or worse represented 61.3% of the patient population in a clinical setting. When a published correction factor is applied to convert Snellen to ETDRS vision, 48.1% of the DME patient population present with ETDRS BCVA of 20/50 or worse. While DRCR.net Protocol T did not include patients with visual acuity better than 20/32 or worse than 20/320 in their clinical trial, our analysis included all patients presenting with anti-VEGF naive DME regardless of VA. This shows a more representative sample of DME patients that one would find in a real clinical setting and represents the first published report on this subject.

Conclusions : In DRCR.net Protocol T, about 50% of the patients enrolled had baseline ETDRS BCVA of 20/32 to 20/40, and the remaining 50% had baseline ETDRS BCVA of 20/50 or worse. When comparing the proportion of patients in Group 1 (20/32 to 20/40) to those in Group 2 (20/50 or worse), between the randomized prospective DRCR.net trial and this real world retrospective clinical chart review, we found that the 50:50 ratio of the randomized trial does accurately represent how patients present in a clinic. The results of this real world retrospective chart review show that when a published correction factor is applied, about half (48.1%) of DME patients present with ETDRS BCVA of 20/50 or worse.

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

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