Abstract
Purpose :
Limited data are available to guide clinicians regarding management of patients with center-involving diabetic macular edema (ci-DME) and Snellen visual acuity (VA) of 20/30 or better. We aimed to describe the clinical course of these patients.
Methods :
Retrospective study conducted at the Johns Hopkins Hospital, Wilmer Eye Institute. Patients were included if: 1) aged ≥18 years with a diagnosis of type 2 diabetes 2) seen between July 2013 and May 2018 3) spectral domain optical coherence tomography (SD-OCT) imaging done either on or after the date of diagnosis of DME, 4) visual acuity (VA) of 20/30 or better in ≥ 1 eye and 5) follow-up duration equal to ≥ 3 clinic visits. Patients were identified using billing codes for DME. SD-OCT scans were reviewed to confirm ci-DME. Ci-DME was defined as retinal thickening ≥305 microns for females and ≥320 microns for males within central 1mm of the ETDRS grid or presence of cysts due to DM. One eye of each patient was randomly selected for analysis.
Results :
121 patients (121 eyes) with ci-DME met the inclusion criteria. Mean patient age was 63.8 ±10.9 years. Mean (SD) central 1mm thickness and VA at baseline were 316.5 (±63.2) µm and 0.1 (±0.1) logMAR [Snellen Equivalent (SE) 20/25], 60% were phakic. Mean duration of follow-up was 1.8 (±0.7) years. Mean logMAR VA at final follow-up visit was 0.2 (±0.2) logMAR [SE 20/32]. 67 eyes (55.4%) underwent treatment: 66 received anti-VEGF injections and 1 received focal laser. Mean number of injections performed was 6.4 (±4.6), 2.8 injections/year. Baseline and final VA was comparable between the 2 groups that underwent treatment versus those that did not at 0.1 (±0.1) logMAR (p=0.9) and 0.2 (±0.0) logMAR (p=0.7), respectively. Mean change in VA in both groups was +0.1 logMAR at the end of follow-up (p=0.8).
Conclusions :
After an average of 2 years of follow-up there was no statistically significant difference in final visual acuity or retinal thickness irrespective of whether patients received or did not receive treatment with anti-VEGF agents.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.