April 2010
Volume 51, Issue 13
ARVO Annual Meeting Abstract  |   April 2010
Observational Study of Subclinical Diabetic Macular Edema
Author Affiliations & Notes
  • J. W. Kitchens
    Ophthalmology, Retina Associates of Kentucky, Lexington, Kentucky
  • Diabetic Retinopathy Clinical Research Network
    Ophthalmology, Retina Associates of Kentucky, Lexington, Kentucky
  • Footnotes
    Commercial Relationships  J.W. Kitchens, None.
  • Footnotes
    Support  Supported through a cooperative agreement from the National Eye Institute and the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 4246. doi:
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      J. W. Kitchens, Diabetic Retinopathy Clinical Research Network; Observational Study of Subclinical Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4246.

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

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Purpose: : To determine how often subclinical diabetic macular edema (DME) increases in thickness to a clinically apparent level of macular edema or is treated during a 2 year period.

Methods: : Study participants with subclinical DME, defined as absence of edema on biomicroscopic exam of the macular center with a center point thickness on optical coherence tomography (OCT) between 225 and 299 microns, were enrolled among 18 community-based and institutional clinical sites in the Diabetic Retinopathy Clinical Research Network (DRCR.net). Annual follow-up visits 1 and 2 years after enrollment included OCT to identify eyes that had an increase in center point thickness of at least 50 microns and progressed to a thickness of at least 300 microns (OCT progression). Data was collected on any treatment that was delivered for DME during the 2 year study. The primary outcome variable was OCT progression or treatment for DME.

Results: : Both eyes among 613 study participants (1,226 eyes) were screened to identify and enroll 4.0% of these eyes (49 eligible eyes among 44 study participants). The cumulative probability of meeting the primary outcome was 28% (95% CI: 15%, 39%) by 1 year and 38% (95% CI: 23%, 50%) by 2 years (Figure 1).

Conclusions: : Subclinical DME appears to be relatively uncommon. With at least annual follow-up, screening for subclinical DME does not seem warranted among most eyes with no evidence of DME on clinical examination. This study suggests that between one-quarter and half of eyes with subclinical DME will progress to more definitive thickening or be judged to need treatment for DME within 2years after its identification.

Keywords: edema • retina • diabetic retinopathy 

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