Abstract
Purpose :
To determine whether early vision gains provide prognostic long-term information regarding visual outcomes in the management of diabetic macular edema.
Methods :
Post-hoc analysis of 68 study eyes that completed 2 year follow-up of the BEVORDEX multi-center randomised clinical trial set in Australia (ClinicalTrials.Gov identifier: NCT01298076). Eyes were stratified by VA (visual acuity) change in the first 12 weeks in to 3 groups: (a) No gain: < 5 letter gain (includes VA loss), (b) Small gain: 5-9 letter gain, (c) Large gain: ≥ 10 letter gain. To account for correlation between eyes from the same patient, generalised estimated equations (GEEs) were used.
Results :
The change in VA in the first 12 weeks was significantly correlated with VA change at 104 weeks (P < 0.001, GEE). This was independent of lens status at baseline (P = 0.726; GEE) or treatment allocation (P = 0.614, GEE). The degree of visual acuity improvement at 12 weeks and 2 years did not correlate with central macular thickness improvement (P = 0.736, GEE). Those study eyes with large VA gain at 12 weeks started with worse baseline VA than the small VA gain group ending up with similar VA at 104 weeks. The no VA gain group had similar baseline VA to the small VA gain group but did not exhibit VA improvement at 12 or 104 weeks.
Conclusions :
Short-term visual gain at 12 weeks is strongly correlated with long-term vision improvement. Early improvement in central macular thickness was not predictive of long-term visual outcomes.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.