TY - JOUR
T1 - Treatment of diabetic macular edema in real-world clinical practice
T2 - The effect of aging
AU - Japan Clinical Retina Study (J-CREST) group
AU - Kusuhara, Sentaro
AU - Shimura, Masahiko
AU - Kitano, Shigehiko
AU - Sugimoto, Masahiko
AU - Muramatsu, Daisuke
AU - Fukushima, Harumi
AU - Takamura, Yoshihiro
AU - Matsumoto, Makiko
AU - Kokado, Masahide
AU - Kogo, Jiro
AU - Sasaki, Mariko
AU - Morizane, Yuki
AU - Utsumi, Takuya
AU - Kotake, Osamu
AU - Koto, Takashi
AU - Terasaki, Hiroto
AU - Hirano, Takao
AU - Ishikawa, Hiroto
AU - Mitamura, Yoshinori
AU - Okamoto, Fumiki
AU - Kinoshita, Takamasa
AU - Kimura, Kazuhiro
AU - Yamashiro, Kenji
AU - Suzuki, Yukihiko
AU - Hikichi, Taiichi
AU - Washio, Noriaki
AU - Sato, Tomohito
AU - Ohkoshi, Kishiko
AU - Tsujinaka, Hiroki
AU - Kondo, Mineo
AU - Takagi, Hitoshi
AU - Murata, Toshinori
AU - Sakamoto, Taiji
N1 - Funding Information:
The authors would like to thank Katsunori Shimada, PhD, working in STATZ Institute Inc. for performing statistical analyses. This work was supported by Bayer, Japan (to S. Kusuhara), and clinical research grant‐in‐aid by Tokyo Medical University.
Publisher Copyright:
© 2022 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
PY - 2022
Y1 - 2022
N2 - Aims/Introduction: In older patients, the management of diabetic macular edema (DME) can be complicated by comorbidities, geriatric syndrome, and socioeconomic status. This study aims to evaluate the effects of aging on the management of DME. Materials and Methods: This is a real-world clinical study including 1,552 patients with treatment-naïve center-involved DME. The patients were categorized into 4 categories by age at baseline (C1, <55; C2, 55–64; C3, 65–74; and C4, ≥75 years). The outcomes were the change in logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA) and central retinal thickness (CRT), and the number of treatments from baseline to 2 years. Results: From baseline to 2 years, the mean changes in logMAR BCVA from baseline to 2 years were −0.01 in C1, −0.06 in C2, −0.07 in C3, and 0.01 in C4 (P = 0.016), and the mean changes in CRT were −136.2 μm in C1, −108.8 μm in C2, −100.6 μm in C3, and −89.5 μm in C4 (P = 0.008). Treatments applied in the 2 year period exhibited decreasing trends with increasing age category on the number of intravitreal injections of anti-VEGF agents (P = 0.06), selecting local corticosteroid injection (P = 0.031), vitrectomy (P < 0.001), and laser photocoagulation outside the great vascular arcade (P < 0.001). Conclusions: Compared with younger patients with DME, patients with DME aged ≥75 years showed less frequent treatment, a lower BCVA gain, and a smaller CRT decrease. The management and visual outcome in older patients with DME would be unsatisfactory in real-world clinical practice.
AB - Aims/Introduction: In older patients, the management of diabetic macular edema (DME) can be complicated by comorbidities, geriatric syndrome, and socioeconomic status. This study aims to evaluate the effects of aging on the management of DME. Materials and Methods: This is a real-world clinical study including 1,552 patients with treatment-naïve center-involved DME. The patients were categorized into 4 categories by age at baseline (C1, <55; C2, 55–64; C3, 65–74; and C4, ≥75 years). The outcomes were the change in logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA) and central retinal thickness (CRT), and the number of treatments from baseline to 2 years. Results: From baseline to 2 years, the mean changes in logMAR BCVA from baseline to 2 years were −0.01 in C1, −0.06 in C2, −0.07 in C3, and 0.01 in C4 (P = 0.016), and the mean changes in CRT were −136.2 μm in C1, −108.8 μm in C2, −100.6 μm in C3, and −89.5 μm in C4 (P = 0.008). Treatments applied in the 2 year period exhibited decreasing trends with increasing age category on the number of intravitreal injections of anti-VEGF agents (P = 0.06), selecting local corticosteroid injection (P = 0.031), vitrectomy (P < 0.001), and laser photocoagulation outside the great vascular arcade (P < 0.001). Conclusions: Compared with younger patients with DME, patients with DME aged ≥75 years showed less frequent treatment, a lower BCVA gain, and a smaller CRT decrease. The management and visual outcome in older patients with DME would be unsatisfactory in real-world clinical practice.
KW - Aging
KW - Diabetes
KW - Diabetic macular edema
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U2 - 10.1111/jdi.13801
DO - 10.1111/jdi.13801
M3 - Article
C2 - 35389565
AN - SCOPUS:85131361803
JO - Journal of Diabetes Investigation
JF - Journal of Diabetes Investigation
SN - 2040-1116
ER -