Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study

© 2019, The Author(s). Aims: To describe and compare the functional and anatomical outcomes of untreated and treated diabetic macular edema (DME) in eyes with very good baseline visual acuity (VA) in a real-world setting. Methods: A 12-month, retrospective, multicenter, observational cohort study, i...

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Main Authors: Catharina Busch, Samantha Fraser-Bell, Dinah Zur, Patricio J. Rodríguez-Valdés, Zafer Cebeci, Marco Lupidi, Adrian T. Fung, Pierre Henry Gabrielle, Ermete Giancipoli, Voraporn Chaikitmongkol, Mali Okada, Inês Laíns, Ana Rita Santos, Paradee Kunavisarut, Anna Sala-Puigdollers, Jay Chhablani, Malgorzata Ozimek, Assaf Hilely, Jan Darius Unterlauft, Anat Loewenstein, Matias Iglicki, Matus Rehak
Format: Journal
Published: 2019
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/65423
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spelling th-cmuir.6653943832-654232019-08-05T04:42:12Z Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study Catharina Busch Samantha Fraser-Bell Dinah Zur Patricio J. Rodríguez-Valdés Zafer Cebeci Marco Lupidi Adrian T. Fung Pierre Henry Gabrielle Ermete Giancipoli Voraporn Chaikitmongkol Mali Okada Inês Laíns Ana Rita Santos Paradee Kunavisarut Anna Sala-Puigdollers Jay Chhablani Malgorzata Ozimek Assaf Hilely Jan Darius Unterlauft Anat Loewenstein Matias Iglicki Matus Rehak Biochemistry, Genetics and Molecular Biology Medicine © 2019, The Author(s). Aims: To describe and compare the functional and anatomical outcomes of untreated and treated diabetic macular edema (DME) in eyes with very good baseline visual acuity (VA) in a real-world setting. Methods: A 12-month, retrospective, multicenter, observational cohort study, including DME patients with baseline visual acuity (VA) ≤ 0.1 logMAR (≥ 20/25 Snellen) and central subfield thickness (CST) > 250 µm with intra- and/or subretinal fluid seen on optical coherence tomography. Results: A total of 249 eyes were included, of which 155 were treated and 94 were non-treated during follow-up. Most eyes maintained vision (VA gain or VA loss < 5 letters) at 12 months (treated: 58.1%; non-treated: 73.4%). In non-treated eyes with stable VA within the first 6 months, VA was maintained throughout the follow-up in most cases (86.3%). In non-treated eyes with VA loss ≥ 5 letters within 6 months (36.7%), further observation led to worse visual outcome than treatment (− 4.2 vs. − 7.8 letters, p = 0.013). In eyes in which treatment was initiated at baseline (n = 102), treatment with 8–12 anti-VEGF injections led to better visual outcome compared to treatment with less injections (− 0.3 ± 3.6 letters vs. − 3.8 ± 6.2 letters, p = 0.003). Conclusion: In a real-world setting, the majority of DME patients with very good VA maintained vision at 12 months, regardless of whether the DME was treated or not. This study supports close observation of eyes with DME and very good VA with consideration of treatment when a one line drop in vision is observed. 2019-08-05T04:33:12Z 2019-08-05T04:33:12Z 2019-01-01 Journal 14325233 09405429 2-s2.0-85064079452 10.1007/s00592-019-01310-z https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064079452&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/65423
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Biochemistry, Genetics and Molecular Biology
Medicine
spellingShingle Biochemistry, Genetics and Molecular Biology
Medicine
Catharina Busch
Samantha Fraser-Bell
Dinah Zur
Patricio J. Rodríguez-Valdés
Zafer Cebeci
Marco Lupidi
Adrian T. Fung
Pierre Henry Gabrielle
Ermete Giancipoli
Voraporn Chaikitmongkol
Mali Okada
Inês Laíns
Ana Rita Santos
Paradee Kunavisarut
Anna Sala-Puigdollers
Jay Chhablani
Malgorzata Ozimek
Assaf Hilely
Jan Darius Unterlauft
Anat Loewenstein
Matias Iglicki
Matus Rehak
Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study
description © 2019, The Author(s). Aims: To describe and compare the functional and anatomical outcomes of untreated and treated diabetic macular edema (DME) in eyes with very good baseline visual acuity (VA) in a real-world setting. Methods: A 12-month, retrospective, multicenter, observational cohort study, including DME patients with baseline visual acuity (VA) ≤ 0.1 logMAR (≥ 20/25 Snellen) and central subfield thickness (CST) > 250 µm with intra- and/or subretinal fluid seen on optical coherence tomography. Results: A total of 249 eyes were included, of which 155 were treated and 94 were non-treated during follow-up. Most eyes maintained vision (VA gain or VA loss < 5 letters) at 12 months (treated: 58.1%; non-treated: 73.4%). In non-treated eyes with stable VA within the first 6 months, VA was maintained throughout the follow-up in most cases (86.3%). In non-treated eyes with VA loss ≥ 5 letters within 6 months (36.7%), further observation led to worse visual outcome than treatment (− 4.2 vs. − 7.8 letters, p = 0.013). In eyes in which treatment was initiated at baseline (n = 102), treatment with 8–12 anti-VEGF injections led to better visual outcome compared to treatment with less injections (− 0.3 ± 3.6 letters vs. − 3.8 ± 6.2 letters, p = 0.003). Conclusion: In a real-world setting, the majority of DME patients with very good VA maintained vision at 12 months, regardless of whether the DME was treated or not. This study supports close observation of eyes with DME and very good VA with consideration of treatment when a one line drop in vision is observed.
format Journal
author Catharina Busch
Samantha Fraser-Bell
Dinah Zur
Patricio J. Rodríguez-Valdés
Zafer Cebeci
Marco Lupidi
Adrian T. Fung
Pierre Henry Gabrielle
Ermete Giancipoli
Voraporn Chaikitmongkol
Mali Okada
Inês Laíns
Ana Rita Santos
Paradee Kunavisarut
Anna Sala-Puigdollers
Jay Chhablani
Malgorzata Ozimek
Assaf Hilely
Jan Darius Unterlauft
Anat Loewenstein
Matias Iglicki
Matus Rehak
author_facet Catharina Busch
Samantha Fraser-Bell
Dinah Zur
Patricio J. Rodríguez-Valdés
Zafer Cebeci
Marco Lupidi
Adrian T. Fung
Pierre Henry Gabrielle
Ermete Giancipoli
Voraporn Chaikitmongkol
Mali Okada
Inês Laíns
Ana Rita Santos
Paradee Kunavisarut
Anna Sala-Puigdollers
Jay Chhablani
Malgorzata Ozimek
Assaf Hilely
Jan Darius Unterlauft
Anat Loewenstein
Matias Iglicki
Matus Rehak
author_sort Catharina Busch
title Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study
title_short Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study
title_full Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study
title_fullStr Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study
title_full_unstemmed Real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the OBTAIN study
title_sort real-world outcomes of observation and treatment in diabetic macular edema with very good visual acuity: the obtain study
publishDate 2019
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064079452&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/65423
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