July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
CORRELATION BETWEEN VISUAL ACUITY AND CENTRAL RETINAL THICKNESS FOR PATIENTS TREATED WITH ANTI-VEGF FOR DIABETIC MACULAR OEDEMA
Author Affiliations & Notes
  • Charles Hennings
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
  • Christoph Kern
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
    Department of Ophthalmology, University Hospital LMU, Munich, Germany, Germany
  • Dun Jack Fu
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
  • Karsten Ulrich Kortuem
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
    Department of Ophthalmology, University Hospital LMU, Munich, Germany, Germany
  • Josef Huemer
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
    Eye Department, Tauernklinikum, Zell am See, Austria
  • Livia Faes
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
  • Siegfried Karl Wagner
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
  • Praveen Patel
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
  • Konstantinos Balaskas
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
    National Institute for Health and Research (NIHR) Biomedical Center, Moorfields Eye Hospital, London, UK, United Kingdom
  • Dawn A Sim
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
    National Institute for Health and Research (NIHR) Biomedical Center, Moorfields Eye Hospital, London, UK, United Kingdom
  • Pearse Andrew Keane
    Moorfields Eye Hospital, London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom
    National Institute for Health and Research (NIHR) Biomedical Center, Moorfields Eye Hospital, London, UK, United Kingdom
  • Footnotes
    Commercial Relationships   Charles Hennings, None; Christoph Kern, None; Dun Jack Fu, None; Karsten Kortuem, None; Josef Huemer, None; Livia Faes, None; Siegfried Wagner, None; Praveen Patel, None; Konstantinos Balaskas, Bayer (R); Dawn Sim, None; Pearse Keane, Allergan (R), Bayer (R), Bayer (S), Carl Zeiss Meditec (R), DeepMind (C), Haag-Streit (R), Heidelberg Engineering (R), Novartis (R), Novartis (S), Optos (C), Topcon (R)
  • Footnotes
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Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3653. doi:
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      Charles Hennings, Christoph Kern, Dun Jack Fu, Karsten Ulrich Kortuem, Josef Huemer, Livia Faes, Siegfried Karl Wagner, Praveen Patel, Konstantinos Balaskas, Dawn A Sim, Pearse Andrew Keane; CORRELATION BETWEEN VISUAL ACUITY AND CENTRAL RETINAL THICKNESS FOR PATIENTS TREATED WITH ANTI-VEGF FOR DIABETIC MACULAR OEDEMA. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3653.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Frequency of intravitreal anti-VEGF treatments for diabetic macular oedema (DMO) in real-life clinical settings is reported to be less than in pivotal studies. There is increasing controversy as to what extent this practice compromises structural outcomes in everyday clinic patient cohorts. We performed a retrospective data-warehouse study including optical coherence tomography (OCT) images to correlate structural with visual acuity outcomes in eyes undergoing intravitreal therapy for DMO in a real-life setting.

Methods : A data-warehouse query for all eyes receiving receiving intravitreal injections for DMO between March 2013 and October 2018 was performed. Corresponding raw OCT files per eye were exported to a virtual network to extract retinal thickness values following the 9 circula macular grids defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) group. Mean visual acuity and change in visual acuity over 4 years of observation was correlated with baseline visual acuity. For linear regression analyses, the Kendall and Spearman method were used to derive rank-based correlation coefficients for non-parametric data.

Results : Our cohort comprised 1220 eyes at baseline (before starting anti-VEGF treatment), with 916, and 477 eyes at 3 months and 12 months following baseline, respectively. A wide range of visual acuities (VA) was observed for any central retinal thickness (CRT) at each time point (Figure 1a). The line of best fit at each time-point demonstrated a trend for inverse correlation between VA and CRT, with correlation coefficients of: -0.27 rho and -0.18 tau at baseline; -0.17 rho and -0.12 tau at 3 months; and -0.18 rho and -0.12 tau at 12 months, all with p < 0.0001. Statistically significant associations (all p < 0.0001) was also observed when a change in VA was plotted against a change in CRT at both 3 (-0.34 rho and -0.24 tau) and 12 months (-0.35 rho and -0.25) (Figure 1b).

Conclusions : Anti-VEGF is an effective treatment for DMO patients to achieve and maintain structural improvement i.e. a decrease in CRT. Here we see that CRT and a change in CRT inversely correlates with VA and a change in VA, respectively.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Figure 1: a) CRT (µm) vs. VA (ETDRS letters) at baseline (red), 3 (blue), and 12 months (green). b) change in CRT and VA from baseline to 3 (teal) and 12 (red) months. Solid lines show regression lines with with gray fill as 95% CI.

Figure 1: a) CRT (µm) vs. VA (ETDRS letters) at baseline (red), 3 (blue), and 12 months (green). b) change in CRT and VA from baseline to 3 (teal) and 12 (red) months. Solid lines show regression lines with with gray fill as 95% CI.

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