May 2005
Volume 46, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2005
A Severity Scale for Diabetic Macular Edema (DME)
Author Affiliations & Notes
  • R. Gangnon
    Biostatistics and Medical Informatics,
    UW–Madison, Madison, WI
  • M.D. Davis
    Ophthalmology & Visual Sciences,
    UW–Madison, Madison, WI
  • L.D. Hubbard
    Ophthalmology & Visual Sciences,
    UW–Madison, Madison, WI
  • L.M. Aiello
    Joslin Diabetes Center, Harvard Medical School, Boston, MA
  • E.Y. Chew
    National Eye Institute, National Institutes of Health, Bethesda, MD
  • F.L. Ferris, III
    National Eye Institute, National Institutes of Health, Bethesda, MD
  • Early Treatment Diabetic Retinopathy Study Research Group
    UW–Madison, Madison, WI
  • Footnotes
    Commercial Relationships  R. Gangnon, None; M.D. Davis, None; L.D. Hubbard, None; L.M. Aiello, None; E.Y. Chew, None; F.L. Ferris, III, None.
  • Footnotes
    Support  Contracts from NEI, NIH, USDHHS
Investigative Ophthalmology & Visual Science May 2005, Vol.46, 3269. doi:
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    • Get Citation

      R. Gangnon, M.D. Davis, L.D. Hubbard, L.M. Aiello, E.Y. Chew, F.L. Ferris, III, Early Treatment Diabetic Retinopathy Study Research Group; A Severity Scale for Diabetic Macular Edema (DME) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3269.

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

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Abstract
 
Abstract:
 

To develop a severity scale for DME derived from eyes enrolled in the ETDRS and based on stereo photographic gradings of degree of retinal thickening (RT) at the center of the macula (RT_CM) and area of RT within 1 disc diameter (DD) of center (RT_1DD).

 

Mean baseline visual acuity (VA) scores were tabulated for eyes cross–classified by RT_CM and RT_1DD. Groups with similar VA scores were combined using cluster analysis and clinical judgment, producing an 8–step scale.

 

See table below. Mean VA Score at Baseline

 

 

Note: (1) all eyes with RT_1DD <0.5DA and any degree of RT_CM >0 have similar VA; (2) eyes with the same degree of RT_CM have decreasing VA as RT_1DD increases; (3) the cells combined to form steps 5, 6, 7 and 8a are diagonal pairs, as might be expected when two additive risk factors are cross classified. The scale facilitates concurrent tracking of changes in morphology and VA. For example, among 438 eyes assigned to deferral of photocoagulation and in step 3 at baseline, 320 (73%) were in step 3 or lower at 3 years and 8% of these eyes had moderate (≥15 letter) VA loss (MVL), while of the 33 eyes (8%) that had worsened to step 7 or 8 at 3 years 33% had MVL. Among 232 eyes in step 8 at baseline, the 1/3 that improved to step 3 or better at 3 years had a 22% MVL rate, while the 1/3 that remained in steps 7 or 8 had a 63% MVL rate.<BR The scale facilitates concurrent analyses of change in DME morphology and VA. It may be useful in further analyses of ETDRS data and in planning clinical trials.

 

 
Keywords: diabetic retinopathy • clinical (human) or epidemiologic studies: natural history • macula/fovea 
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