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

Masahiko Shimura, Shigehiko Kitano, Daisuke Muramatsu, Harumi Fukushima, Yoshihiro Takamura, Makiko Matsumoto, Masahide Kokado, Jiro Kogo, Mariko Sasaki, Yuki Morizane, Takuya Utsumi, Takashi Koto, Shozo Sonoda, Takao Hirano, Hiroto Ishikawa, Yoshinori Mitamura, Fumiki Okamoto, Takamasa Kinoshita, Kazuhiro Kimura, Masahiko SugimotoKenji Yamashiro, Yukihiko Suzuki, Taiichi Hikichi, Noriaki Washio, Tomohito Sato, Kishiko Ohkoshi, Hiroki Tsujinaka, Sentaro Kusuhara, Mineo Kondo, Hitoshi Takagi, Toshinori Murata, Taiji Sakamoto

Research output: Contribution to journalArticle

Abstract

Background/aims: To 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). Methods: Retrospective 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. Results: Although 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. Conclusion: For 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.

Original languageEnglish
JournalBritish Journal of Ophthalmology
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • epidemiology
  • macula
  • retina

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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    Shimura, M., Kitano, S., Muramatsu, D., Fukushima, H., Takamura, Y., Matsumoto, M., Kokado, M., Kogo, J., Sasaki, M., Morizane, Y., Utsumi, T., Koto, T., Sonoda, S., Hirano, T., Ishikawa, H., Mitamura, Y., Okamoto, F., Kinoshita, T., Kimura, K., ... Sakamoto, T. (Accepted/In press). Real-world management of treatment-naïve diabetic macular oedema: 2-year visual outcome focusing on the starting year of intervention from STREAT-DMO study. British Journal of Ophthalmology. https://doi.org/10.1136/bjophthalmol-2019-315726