Real-world management of treatment-naïve diabetic macular oedema: 2-year visual outcome focusing on the starting year of intervention from STREAT-DMO study

Abstract

Background/aimsTo investigate the yearly change of real-world outcomes for best corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve diabetic macular oedema (DMO).MethodsRetrospective analysis of aggregated, longitudinal medical records obtained from 27 retina specialised institutions in Japan from Survey of Treatment for DMO database. A total of 2049 treatment-naïve centre involving DMO eyes of which the initial intervention started between 2010 and 2015, and had been followed for 2 years, were eligible. As interventions, antivascular endothelial growth factor (VEGF) agents, local corticosteroids, macular photocoagulation and vitrectomy were defined. In each eye, baseline and final BCVA, the number of each intervention for 2 years was extracted. Each eye was classified by starting year of interventional treatment.ResultsAlthough baseline BCVA did not change by year, 2-year improvement of BCVA had been increased, and reached to +6.5 letters in the latest term. There is little difference among starting year about proportions of eyes which BCVA gained >15 letters, in contrast to those which lost >15 letters were decreased by year. The proportion of eyes receiving anti-VEGF therapy was dramatically increased, while those receiving the other therapies were gradually decreased. The proportion of eyes which maintained socially good vision of BCVA>20/40 has been increased and reached to 59.0% in the latest term.ConclusionFor recent years, treatment patterns for DMO have been gradually but certainly changed; as a result, better visual gain, suppression of worsened eyes and better final BCVA have been obtained. Anti-VEGF therapy has become the first-line therapy and its injection frequency has been increasing.

Real-World Data on Intravitreal Aflibercept for Macular Edema Secondary to Central Retinal Vein Occlusion: 24-Month Outcomes

“…Recovery and retention of useful visual acuity (decimal BCVA ≥0.5) is a primary treatment goal for macular disease. 26 In the present study, BCVA was improved or maintained at 24 months from baseline in 89.7% of patients, whereas only 37.5% had a decimal BCVA >0.5 at the final visit. This suggests that the rate of achieving the treatment goal in current clinical practice might be insufficient and that there is a need for early intervention and an improved regimen (eg, a treat-and-extend regimen) in order to obtain better vision and achieve better patient satisfaction.…”

The Impact of Interval between Recurrence and Reinjection in Anti-VEGF Therapy for Diabetic Macular Edema in Pro Re Nata Regimen

“…In this study, the prompt group received 5.11 ± 2.59 injections per year with change in BCVA of −0.14 ± 0.29, and the deferred group received 3.01 ± 1.55 injections with BCVA change of −0.04 ± 0.36. In the Mercury study, a recent multicenter report of PRN regimen with ranibizumab in Japan, the change in BCVA were −0.10 ± 0.24 in the eyes that underwent five or more injections and 0.03 ± 0.31 in the eyes that received 3-4 injections per year [18]. With regard to the number of injections and the change in visual acuity, the results of both studies showed comparable outcomes.…”

Treatment of diabetic macular edema in real‐world clinical practice: The effect of aging

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