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.