September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
The presence of diabetic macular edema in patients with new onset vitreous hemorrhage associated with proliferative diabetic retinopathy
Author Affiliations & Notes
  • Jeremiah Brown
    Retina, Brown Retina Institute, San Antonio, Texas, United States
    Ophthalmology, University of Texas Health Science Center, San Antonio, San Antonio, Texas, United States
  • Jeremiah Brown
    Retina, Brown Retina Institute, San Antonio, Texas, United States
    Ophthalmology, University of Texas Health Science Center, San Antonio, San Antonio, Texas, United States
  • Jeremiah Brown
    Retina, Brown Retina Institute, San Antonio, Texas, United States
    Ophthalmology, University of Texas Health Science Center, San Antonio, San Antonio, Texas, United States
  • Footnotes
    Commercial Relationships   Jeremiah Brown, Roche (R); Jeremiah Brown, Roche (R); Jeremiah Brown, Roche (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3239. doi:
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      Jeremiah Brown, Jeremiah Brown, Jeremiah Brown; The presence of diabetic macular edema in patients with new onset vitreous hemorrhage associated with proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3239.

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

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Abstract

Purpose : Anti-VEGF medications have been shown to be efficacious in treating patients with proliferative diabetic retinopathy. Currently, proliferative diabetic retinopathy is not an indicated diagnosis for the use of anti-VEGF medications unless there is associated diabetic macular edema. The hypothesis of this study is that most patients with acute vitreous hemorrhage due to proliferative diabetic retinopathy do not have associated diabetic macular edema. Our goal is to evaluate the frequency of diabetic macular edema in patients with new onset vitreous hemorrhage due to proliferative diabetic retinopathy.

Methods : Medical records were reviewed from a referral-based retina practice. Patients presenting from January 2015 through November 2015 with a visually significant vitreous hemorrhage were identified. Visually significant vitreous hemorrhage was defined as visual acuity 20/40 or worse on a Snellen chart. In this retrospective, observational clinical study, medical records were reviewed for the presence or absence of foveal involving macular edema. If it was not possible to determine whether or not diabetic macular edema was present at time of presentation, follow-up records were reviewed.

Results : Fifty-three consecutive patients with visually significant new onset vitreous hemorrhage were identifed. The patients ranged in age between 33 and 70 years of age. There were 28 male patients and 23 female patients in this cohort. Twelve patients (23%) had associated foveal involving diabetic macular edema. In 41 patients (77%), diabetic macular edema was not present.

Conclusions : In a referral-based retina practice, 77% of patients presenting with visually significant vitreous hemorrhage due to diabetic retinopathy, do not have associated diabetic macular edema. Recent controlled studies have demonstrated positive visual outcomes in patients with proliferative diabetic retinopathy treated with anti-VEGF medications. For most patients with diabetic retinopathy, vitreous hemorrhage, without the presence of diabetic macular edema, is not an indicated diagnosis for the use of anti-VEGF medications. Expanding the indications for the use of anti-VEGF medications in patients with vitreous hemorrhage and proliferative diabetic retinopathy will enable more patients to receive this beneficial treatment.

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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