September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Shape Discrimination Hyperacuity (SDH) Improvement After Treatment of Diabetic Macular Edema (DME): One-Year Results of the DRAMA Study
Author Affiliations & Notes
  • Yi-Zhong Wang
    Retina Foundation of the Southwest, Dallas, Texas, United States
    Ophthalmology, UT Southwestern Medical Center, Dallas, Texas, United States
  • Yu-Guang He
    Ophthalmology, UT Southwestern Medical Center, Dallas, Texas, United States
  • Karl G Csaky
    Texas Retina Associates, Dallas, Texas, United States
    Retina Foundation of the Southwest, Dallas, Texas, United States
  • Luis Rodriguez
    Retina Foundation of the Southwest, Dallas, Texas, United States
  • Paulina Mejia
    Retina Foundation of the Southwest, Dallas, Texas, United States
  • Song Zhang
    Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas, United States
  • Michael B Bartlett
    Vital Art & Science, LLC, Richardson, Texas, United States
  • Footnotes
    Commercial Relationships   Yi-Zhong Wang, Vital Art & Science, LLC (F), Vital Art & Science, LLC (I), Vital Art & Science, LLC (C), Vital Art & Science, LLC (P), Vital Art & Science, LLC (S); Yu-Guang He, Vital Art & Science, LLC (I), Vital Art & Science, LLC (C); Karl Csaky, None; Luis Rodriguez, None; Paulina Mejia, None; Song Zhang, None; Michael Bartlett, Vital Art & Science, LLC (I), Vital Art & Science, LLC (E), Vital Art & Science, LLC (P), Vital Art & Science, LLC (S)
  • Footnotes
    Support  NIH Grant 2R44EY020016-02
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Yi-Zhong Wang, Yu-Guang He, Karl G Csaky, Luis Rodriguez, Paulina Mejia, Song Zhang, Michael B Bartlett; Shape Discrimination Hyperacuity (SDH) Improvement After Treatment of Diabetic Macular Edema (DME): One-Year Results of the DRAMA Study. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : The Diabetic Retinopathy And the MyVisionTrack® (mVTTM) App (DRAMA) study (NCT01728883) was designed to evaluate the feasibility of a handheld SDH test mobile app to assess visual function improvement associated with DME treatment. Here we report 1-year results of the DRAMA study.

Methods : Thirty-three patients with DME were recruited prospectively. At enrollment, the study eye was under active anti-VEGF treatments. Besides the standard care, SDH, visual acuity (VA) and SD-OCT central subfield thickness (CST) were obtained at the initial study visit and every 3 months. The SDH self-test was implemented on an iPad using a spatial 4-alternative forced-choice staircase paradigm (Wang, et al. IOVS 2013 54:ARVO E-Abstract 5019). A linear mixed model was employed to assess SDH/VA changes associated with number of treatment over each 3-month period with the data from 20 patients, who completed the 1-year study and showed no significant CST worsening as defined by < 8 μm increase of CST at both 3 and 6 months (Comyn et al. IOVS 2012 53:7754).

Results : SDH, VA and CST at the initial visit were -0.22±0.18SD logMAR, 0.30±0.17 logMAR, and 360±78 μm, respectively. The average numbers of treatment per patient within each 3-month period from the initial visit were 1.9, 1.1, 0.8, and 0.5, respectively. SDH improved significantly to -0.33±0.19 logMAR at 3 months (p<0.003), which was associated with the number of treatment (p<0.018). SDH continued showing significant improvement at 6 (p<0.002) and 9 months (p<0.023) compared to the initial visit, but the changes at these two 3-month periods were not significantly associated with the number of treatment. SDH at 12 months (-0.30±0.25 logMAR) was not significantly different from the initial visit. VA showed no significant change over the 1-year period. CST at 3, 6, 9 months showed significantly improvement vs. the initial visit (p<0.004). At 12 months, CST (337±108 μm) was borderline worse than at 9 months (301±77 μm, p=0.059). This 3-month change was associated with the number of treatment in the same period (p<0.007).

Conclusions : These results suggest that SDH may be able to reveal visual function improvement associated with anti-VEGF treatments for DME while visual acuity fails to document. mVTTM can be a useful self-testing tool at home to track treatment effect and to detect disease condition changes for patient with DME.

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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