Real-world management of treatment-naïve diabetic macular oedema in Japan: Two-year visual outcomes with and without anti-VEGF therapy in the STREAT-DME study

Masahiko Shimura, Shigehiko Kitano, Daisuke Muramatsu, Harumi Fukushima, Yoshihiro Takamura, Makiko Matsumoto, Masahide Kokado, Jiro Kogo, Mariko Sasaki, Yuki Morizane, Osamu Kotake, 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

2 Citations (Scopus)

Abstract

Background/Aims: To investigate real-world outcomes for best-corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve, centr-involving diabetic macular oedema (DME). Methods: Retrospective analysis of longitudinal medical records obtained from 27 institutions specialising in retinal diseases in Japan. A total of 2049 eyes with treatment-naïve DME commencing intervention between 2010 and 2015 who were followed for 2 years were eligible. Interventions for DME included anti-vascular endothelial growth factor (VEGF) therapy, local corticosteroid therapy, macular photocoagulation and vitrectomy. Baseline and final BCVA (logMAR) were assessed. Eyes were classified by the treatment pattern, depending on whether anti-VEGF therapy was used, into an anti-VEGF monotherapy group (group A), a combination therapy group (group B) and a group without anti-VEGF therapy (group C). Results: The mean 2-year improvement of BCVA was -0.04±0.40 and final BCVA of >20/40 was obtained in 46.3% of eyes. Based on the treatment pattern, there were 427 eyes (20.9%) in group A, 807 eyes (39.4%) in group B and 815 eyes (39.8%) in group C. Mean improvement of BCVA was -0.09±0.39, -0.02±0.40 and -0.05±0.39, and the percentage of eyes with final BCVA of >20/40 was 49.4%, 38.9%, and 52.0%, respectively. Conclusion: Following 2-year real-world management of treatment-naïve DME in Japan, BCVA improved by 2 letters. Eyes treated by anti-VEGF monotherapy showed a better visual prognosis than eyes receiving combination therapy. Despite treatment for DME being selected by specialists in consideration of medical and social factors, a satisfactory visual prognosis was not obtained, but final BCVA remained >20/40 in half of all eyes.

Original languageEnglish
Article number315199
JournalBritish Journal of Ophthalmology
DOIs
Publication statusAccepted/In press - 2019

Keywords

  • diabetic macular oedema
  • multicentre study
  • real-world outcomes
  • treatment pattern

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., Kotake, O., 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 in Japan: Two-year visual outcomes with and without anti-VEGF therapy in the STREAT-DME study. British Journal of Ophthalmology, [315199]. https://doi.org/10.1136/bjophthalmol-2019-315199