Abstract
Purpose :
In the treatment of diabetic macular edema (DME), a multicenter retrospective survey of a 2-year treatment course in clinical practice has been conducted. Here, we report the change of visual acuity (VA) for 2 years focusing upon the starting year of interventional treatment.
Methods :
Based on clinical records, 2049 treatment naïve DME eyes whose interventional treatment started from 2010 to 2015 with follow-up for 2 years or longer at 27 facilities were registered. The VA (logMAR), central retinal thickness (CRT) and the required number of each intervention (anti-VEGF drugs, corticosteroid, macular photocoagulation (MPC), Vitrectomy) during the clinical course were extracted. The change of each variable before and after 2 year was analyzed.
Results :
Interventional treatment was started for 136 eyes (6.6%) in 2010, 285 eyes (13.9%) in 2011, 365 eyes (17.8%) in 2012, 551 eyes (26.9%) in 2013, 468 eyes (22.8%) in 2014, and 244 eyes (11.9%) in 2015. The improvement of VA in each starting year was 0.03±0.41, -0.06±0.38, 0.00±0.43, -0.03±0.45, -0.07±0.34, and -0.13±0.31, in 2010, 2011, 2012, 2013, 2014, and 2015 respectively. The proportion of eyes treated with anti-VEGF drugs was 58.8%, 37.5%, 55.1%, 58.8%, 73.3%, and 73.4%, and proportion of eyes with final VA better than 20/40 was 35.3%, 41.8%, 38.4%, 46.5%, and 51.7%, and 59.0% in 2010, 2011, 2012, 2013, 2014, and 2015 espectively. The proportion of eyes treated with corticosteroid was some 50% in each starting-year. In contrast, those of eyes treated by MPC or vitrectomy were gradually decreased from 40% to 25 %, in 2010 and 2015 respectively.
Conclusions :
From this real-world data, the greater improvement of VA was obtained in a 2-year treatment course of DME dependent on the more recent starting year of intervention. Also, the proportion of eyes treated with anti-VEGF drug increased over time, which may be related to the better prognosis of VA after intervention.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.