Catharina Busch1, Mali Okada2, Dinah Zur3,4, Samantha Fraser-Bell5, Patricio J Rodríguez-Valdés6, Zafer Cebeci7, Marco Lupidi8, Adrian T Fung5,9,10, Pierre-Henry Gabrielle11,12, Ermete Giancipoli13,14, Voraporn Chaikitmongkol15, Inês Laíns16,17,18, Ana Rita Santos17,19, Paradee Kunavisarut15, Anna Sala-Puigdollers20, Jay Chhablani21,22, Malgorzata Ozimek23, Assaf Hilely3,4, Valentin Degenhardt1,24, Anat Loewenstein3,4,25, Matias Iglicki26, Matus Rehak1. 1. Department of Ophthalmology, University Hospital Leipzig, Leipzig, Germany. 2. Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia. 3. Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South Wales, Australia. 6. Instituto de Oftalmología y Ciencias Visuales, Escuela de Medicina, Tecnologico de Monterrey, Monterrey, Mexico. 7. Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. 8. Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, Perugia, Italy. 9. Department of Ophthalmology, Westmead Hospital, Sydney, New South Wales, Australia. 10. Faculty of Medicine and Health Sciences, Macquarie University Hospital, Sydney, New South Wales, Australia. 11. Ophthalmology Department, Dijon University Hospital, Dijon, France. 12. Center for Taste and Feeding Behaviour, INRA, UMR1324, Dijon, France. 13. Department of Surgical, Microsurgical and Medical Sciences, Eye Clinic, University of Sassari, Sassari, Italy. 14. Department of Biomedical Sciences, University of Sassari, Sassari, Italy. 15. Retina Division, Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. 16. Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 17. Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal. 18. Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA. 19. Department of Orthoptics, Superior School of Health, Polytechnic of Porto, Porto, Portugal. 20. Institut Clínic d'Oftalmologia (ICOF), Hospital Clínic de Barcelona, Barcelona, Spain. 21. UPMC Eye Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 22. L.V. Prasad Eye Institute, Banjara Hills, Hyderabad, India. 23. Department of General Ophthalmology and Pediatric Ophthalmology Service, Medical University of Lublin, Lublin, Poland. 24. Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany. 25. Incumbent, Sydney A. Fox chair in Ophthalmology, Tel Aviv University, Tel Aviv, Israel. 26. Private Retina Service, University of Buenos Aires, Buenos Aires, Argentina.
Abstract
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.
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.
Authors: Sebastian Bemme; Amelie Heins; Peer Lauermann; Marcus Werner Storch; Mohammed Haitham Khattab; Hans Hoerauf; Nicolas Feltgen; Christian van Oterendorp Journal: Ophthalmol Sci Date: 2021-06-05
Authors: José Ignacio Fernández-Vigo; Inés Contreras; María José Crespo; Carlos Beckford; Ignacio Flores-Moreno; Rosario Cobo-Soriano; Jesús Pareja; María Dolores Martín; Luis Moreno; Luis Arrevola-Velasco Journal: Clin Ophthalmol Date: 2022-09-19