June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Bilateral macular edema (ME) at baseline and 1 year due to diabetic retinopathy (DR), neovascular age-related macular degeneration (nAMD), and retinal vein occlusion (RVO)
Author Affiliations & Notes
  • Priya Kulkarni
    Genentech Inc, South San Francisco, California, United States
  • Shih-Chen Chang
    Genentech Inc, South San Francisco, California, United States
  • Ching-Yi (James) Chuo
    Genentech Inc, South San Francisco, California, United States
  • Elizabeth Finucane
    Genentech Inc, South San Francisco, California, United States
  • Natalia Callaway
    Genentech Inc, South San Francisco, California, United States
  • Daniela Ferrara
    Genentech Inc, South San Francisco, California, United States
    Tufts University, Medford, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Priya Kulkarni, Genentech (E); Shih-Chen Chang, Genentech (E); Ching-Yi (James) Chuo, Genentech (E); Elizabeth Finucane, Genentech (E); Natalia Callaway, Genentech (E), Pear Therapeutic (I), Virta Health (I), Vohra Wound Physicians (I); Daniela Ferrara, Genentech (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1129. doi:
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      Priya Kulkarni, Shih-Chen Chang, Ching-Yi (James) Chuo, Elizabeth Finucane, Natalia Callaway, Daniela Ferrara; Bilateral macular edema (ME) at baseline and 1 year due to diabetic retinopathy (DR), neovascular age-related macular degeneration (nAMD), and retinal vein occlusion (RVO). Invest. Ophthalmol. Vis. Sci. 2021;62(8):1129.

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

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Abstract

Purpose : The most common causes of ME (DR, nAMD, and RVO) can affect both eyes. Bilateral ME significantly impacts a patient's visual function and ability to perform tasks of daily living. This study aims to understand the prevalence of bilateral ME at initial diagnosis (baseline) for patients with DR, nAMD and RVO, and second eye involvement at 1 year (1yr) for patients with unilateral ME at baseline.

Methods : A retrospective observational claims database study, using Truven® marketscan, in adults (≥ 18 years) with at least one diagnosis of ME between Oct 2016 to Jun 2018 as ascertained by the ICD-10 codes. Patients were categorized into three groups according to ME involvement at initial diagnosis: unilateral (right or left), bilateral or unspecified. Patients with unilateral ME at baseline were followed for 1yr to estimate the bilateral involvement (Figure 1).

Results : Out of 37,827 patients with DR, 23,250 (61%) had an initial diagnosis of bilateral ME, 13,492 (36%) had unilateral involvement; and 1085 (3%) unspecified. Of 13,492 with unilateral ME at baseline, only 2490 had at least 1-yr follow-up. Of these, 573 (23%) developed bilateral involvement at 1yr as follows: 14% within the first 3 months, 5% between 4-6 months, 2-3% between 7-9 months and 2% between 10-12 months.

Extrapolating the observed bilateral involvement rate to all patients with unilateral involvement (36%), 8% developed bilateral macular edema at 1yr.

Bilateral rates for nAMD and ME secondary to RVO estimated in an analogous manner are given in Table 1. Of 30,548 nAMD and 11,953 RVO patients, 9,097 (30%) and 473 (4%) had an initial diagnosis of bilateral ME respectively, with additional 9% and 2% developing bilateral ME by 1yr.

Conclusions : At the initial diagnosis, DR patients had a greater proportion of bilateral ME (61%) compared to nAMD (30%) and RVO (4%). Fewer RVO patients developed bilateral ME by 1yr compared to DR and nAMD patients. In summary, ME secondary to DR and nAMD frequently affect both eyes and regular bilateral monitoring is necessary. Evaluation of risk factors associated with more severe disease and vision threatening complications such as ME is warranted.

This is a 2021 ARVO Annual Meeting abstract.

 

Figure 1: Study Design

Figure 1: Study Design

 

Table 1: Bilateral rates of macular edema at initial diagnosis and at one year by disease

Table 1: Bilateral rates of macular edema at initial diagnosis and at one year by disease

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