TY - JOUR
T1 - Baseline predictors for visual acuity loss during observation in diabetic macular oedema with good baseline visual acuity
AU - For the International Retina Group
AU - Busch, Catharina
AU - Okada, Mali
AU - Zur, Dinah
AU - Fraser-Bell, Samantha
AU - Rodríguez-Valdés, Patricio J.
AU - Cebeci, Zafer
AU - Lupidi, Marco
AU - Fung, Adrian T.
AU - Gabrielle, Pierre Henry
AU - Giancipoli, Ermete
AU - Chaikitmongkol, Voraporn
AU - Laíns, Inês
AU - Santos, Ana Rita
AU - Kunavisarut, Paradee
AU - Sala-Puigdollers, Anna
AU - Chhablani, Jay
AU - Ozimek, Malgorzata
AU - Hilely, Assaf
AU - Degenhardt, Valentin
AU - Loewenstein, Anat
AU - Iglicki, Matias
AU - Rehak, Matus
N1 - Publisher Copyright:
© 2020 The Authors. Acta Ophthalmologicas published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Purpose: To investigate clinical baseline characteristics and optical coherence tomography biomarkers predicting visual loss during observation in eyes with diabetic macular oedema (DMO) and good baseline visual acuity (VA). Methods: A sub-analysis of a 12-month, retrospective study, including patients with baseline VA ≤0.1 logMAR (≥20/25 Snellen) and centre-involving DMO. The primary outcome measure was the correlation between baseline characteristics and VA loss ≥10 letters during follow-up. Results: A total of 249 eyes were included in the initial study, of which 147 eyes were observed and 80 eyes received anti-vascular endothelial growth factor (VEGF) treatment at baseline. Visual acuity (VA) loss ≥10 letters occurred in 21.8% (observed cohort) and in 24.3% (treated cohort), respectively. Within observed eyes, presence of hyperreflective foci [HRF; odds ratio (OR): 3.18, p = 0.046], and disorganization of inner retina layers (DRIL; OR: 2.71, p = 0.026) were associated with a higher risk of VA loss ≥10 letters. In observed eyes with a combined presence of HRF, DRIL and ellipsoid zone (EZ) disruption, the risk of VA loss was further increased (OR: 3.86, p = 0.034). In eyes with combined presence of DRIL, HRF and EZ disruption, risk of VA loss was 46.7% (7/15 eyes) in the observed cohort, and 26.3% (5/19 eyes) in the treated cohort (p = 0.26). Conclusion: Patients with DMO and good baseline VA, managed by observation, are of increased risk for VA loss if DRIL, HRF and EZ disruption are present at baseline. Earlier treatment with anti-VEGF in these patients may potentially decrease the risk of VA loss at 12 months.
AB - Purpose: To investigate clinical baseline characteristics and optical coherence tomography biomarkers predicting visual loss during observation in eyes with diabetic macular oedema (DMO) and good baseline visual acuity (VA). Methods: A sub-analysis of a 12-month, retrospective study, including patients with baseline VA ≤0.1 logMAR (≥20/25 Snellen) and centre-involving DMO. The primary outcome measure was the correlation between baseline characteristics and VA loss ≥10 letters during follow-up. Results: A total of 249 eyes were included in the initial study, of which 147 eyes were observed and 80 eyes received anti-vascular endothelial growth factor (VEGF) treatment at baseline. Visual acuity (VA) loss ≥10 letters occurred in 21.8% (observed cohort) and in 24.3% (treated cohort), respectively. Within observed eyes, presence of hyperreflective foci [HRF; odds ratio (OR): 3.18, p = 0.046], and disorganization of inner retina layers (DRIL; OR: 2.71, p = 0.026) were associated with a higher risk of VA loss ≥10 letters. In observed eyes with a combined presence of HRF, DRIL and ellipsoid zone (EZ) disruption, the risk of VA loss was further increased (OR: 3.86, p = 0.034). In eyes with combined presence of DRIL, HRF and EZ disruption, risk of VA loss was 46.7% (7/15 eyes) in the observed cohort, and 26.3% (5/19 eyes) in the treated cohort (p = 0.26). Conclusion: Patients with DMO and good baseline VA, managed by observation, are of increased risk for VA loss if DRIL, HRF and EZ disruption are present at baseline. Earlier treatment with anti-VEGF in these patients may potentially decrease the risk of VA loss at 12 months.
KW - diabetes
KW - diabetic macular oedema
KW - diabetic retinopathy
KW - good visual acuity
KW - intravitreal therapy
KW - macular oedema
KW - observation
UR - http://www.scopus.com/inward/record.url?scp=85081023422&partnerID=8YFLogxK
U2 - 10.1111/aos.14390
DO - 10.1111/aos.14390
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C2 - 32115886
AN - SCOPUS:85081023422
SN - 1755-375X
VL - 98
SP - e801-e806
JO - Acta Ophthalmologica
JF - Acta Ophthalmologica
IS - 7
ER -