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Roomasa Channa, Sidra ZAFAR, Christina Y Weng, Michael V Boland; Visual Outcomes Of Patients With Center-Involving Diabetic Macular Edema And Good Vision. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2640.
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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.
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.
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).
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.
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