First Author: C.Creuzot-Garcher FRANCE
Co Author(s): j. Bouche-Pillon S. Aho-Glele P. Gabriel E. Maupin A. Bron P. Massin
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To report on prognostic factors associated with a good visual acuity recovery during one-year follow-up with intravitreal injections for diabetic macular edema (DME)
University hospital in Dijon
Interventional case series study was performed. One hundred sixty-one eyes of 109 diabetic patients diagnosed with a treatment-naïve DME in the University Hospital of Dijon were followed for 12 months. Patients received three successive monthly intravitreal injections followed by a pro re nata treatment regimen (PRN) with monthly monitoring. Pre-therapeutic clinical features, spectral-domain optical coherence tomography (OCT) and fluorescein angiography parameters were compared between eyes that recovered ≥80 ETDRS letters best-corrected visual acuity during the follow-up and those with <80 ETDRS letters. Multivariate analysis was provided.
At baseline, the median BCVA and central foveal thickness were 58 letters (interquartile range [IQR], 46-69 letters) and 453 microns (IQR, 359-557 microns) respectively. At 12 months, median BCVA was of 72 letters (IQR, 60-78 letters) with a median number of 6 injections (IQR, 4-8 injections). During the follow-up, 38 eyes (23.5%) recovered ≥80 ETDRS letters BCVA. BCVA at three-months follow-up and final BCVA were correlated (P < .001). Mixed-effects logistic regression analysis showed that good visual outcome was associated with age (P = .004), initial BCVA (P < .001), and ellipsoid zone (EZ) disruption on spectral-domain OCT (P = .007).
Young age, initial BCVA and EZ integrity were reliable prognostic factors to predict good visual acuity in patient treated for DME. Intravitreal injections started from high initial BCVA seems appropriate to recover a good visual acuity.