Optical coherence tomography analysis of patients with untreated diabetic macular edema

Abstract

Purpose : To determine the natural history of untreated diabetic macular edema (DME) over a six to twelve-month period;
To study the predictive values of medical and ophthalmic factors on the natural history of DME.

Methods : Macular optical coherence tomography (OCT) scans of patients with diabetes at a tertiary hospital were assessed. The first scan of an eye that demonstrated the presence of DME was compared with a subsequent scan six to twelve months following the initial scan. Medical and ophthalmic data of the patients/eyes were collected from medical records.

Results : In 97 eyes, there was no significant change from the baseline visual acuity 6/9 (inter-quartile range 6/6 – 6/12) or from the baseline median central subfield thickness (290 μm, inter-quartile range 270 μm – 312 μm) over a median duration of eight months. The numbers of eyes where the central subfield thickness (CSFT) had worsened, improved, or remained stable were 16 (16%), 6 (6%), and 74 (76%), respectively. Patients with hemoglobin A1c of greater than 8.5% were 5.7 times more likely to develop CSFT worsening (95% confidence interval 1.1 – 30.1, P = 0.038). Patients with shorter duration of diabetes or with greater baseline central subfield thicknesses were more likely to demonstrate reductions in CSFT.

Conclusions : The majority of eyes with diabetic macular edema identified on optical coherence tomography had stable central retinal thicknesses without treatment over a median duration of eight months. Hemoglobin A1c, duration of diabetes and central subfield thickness on optical coherence tomography may be useful for risk stratification.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.