Abstract
Purpose :
To describe the clinical management of diabetic macular edema (DME) by Spanish retinologists in clinical practice.
Methods :
This was an observational, retrospective, and multicenter study. Forty-two retinologists participated in the study and collected clinical and demographic characteristics from clinical histories of adult DME patients and completed the questionnaires about diagnosis, treatments and follow-up patterns.
Results :
A total of 256 DME patients, 351 eyes [161 (46%) unilateral; 190 (54%) bilateral] with a mean (SD) age of 65.2 (10.4) years and mostly men (60.9%) participated in the study. Retinologists considered the progressive loss of visual acuity (VA) as the main symptom suggesting DME (40.9%). The most frequent diagnostic tests were ETDRS, biomicroscopy, OCT (95.5% each) and fluorescein angiography (68.2%). DME first-line treatment was mainly based on anti-VEGF drugs (59.1%, and 100% ranibizumab), and 95.5% of retinologists opted for laser photocoagulation as concomitant treatment. More than half of retinologists (52.3%) used 3 initial anti-VEGF injections, and 47.7% scheduled bi-monthly follow-up visits during the first year post-diagnosis, extended to quarterly visits afterwards (38.6%). The ETDRS showed stabilization or even improvement of VA after treatment, from 60.4 (17.7) to 65.7 (19.6) letters for unilateral and from 59.7 (18.8] to 64.8 (15.2) letters for bilateral DME patients. A reduction in mean foveal thickness was also observed: 409.9 (119.8) µm to 318.7 (76.8) µm for unilateral and 416.2 (126.5) µm to 346.5 (105.0) µm for bilateral DME patients.
Conclusions :
The results of this study showed homogeneous criteria regarding diagnosis, treatment and follow-up of DME by the Spanish retinologists in clinical practice. The treatments used achieved clinically relevant improvements in visual acuity and reduction in foveal thickness. The most frequent treatments for VA impairment due to DME used by the majority of retinologists were anti-VEGF injections.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.