Natural history of diabetic macular edema and factors predicting outcomes in sham-treated patients (MEAD study)

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art_YOON_Natural_history_of_diabetic_macular_edema_and_factors_2019.PDF (681.39 KB)
Citações na Scopus
9
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Autores
YOON, Young Hee
BOYER, David S.
MATURI, Raj K.
BANDELLO, Francesco
BELFORT, Rubens
AUGUSTIN, Albert J.
LI, Xiao-Yan
BAI, Zhanying
HASHAD, Yehia
ABUJAMRA, Suel
Citação
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, v.257, n.12, p.2639-2653, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purpose To describe the natural history of diabetic macular edema (DME) with respect to best-corrected visual acuity (BCVA) and central retinal thickness (CRT) outcomes and to identify baseline patient characteristics and systemic factors associated with improvement or worsening of outcomes in sham-treated patients. Methods The study population was sham-treated patients (n = 350) in the 3-year MEAD registration study of dexamethasone intravitreal implant for treatment of DME. Patients had center-involved DME and received sham intravitreal injections in the study eye at >= 6-month intervals. Potential prognostic factors for outcomes were evaluated using multiple linear regression analysis. Results Visual and anatomic outcomes were poorer in patients who left the study early (n = 198) than in study completers (n = 152). Mean change in BCVA from baseline at the last visit with available data was + 0.9 letters; 37.5% of patients had no change in BCVA, 23.2% had gained > 10 letters, and 16.0% had lost > 10 letters. Older age and baseline diabetic retinopathy score > 6 were associated with worse BCVA outcomes; thicker baseline CRT and larger number of hypertension medications used were associated with larger reductions in CRT during the study. Conclusions BCVA and CRT outcomes were variable in this population of DME patients with generally good glycemic control. In DME patients without active treatment, older age and baseline diabetic retinopathy score > 6 were associated with less improvement in BCVA; thicker baseline CRT and a larger number of antihypertensive medications used predicted better improvement in CRT.
Palavras-chave
Diabetic macular edema, Natural history, Prognosis, Risk factors, Visual acuity
URI
https://observatorio.fm.usp.br/handle/OPI/34457
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MOF
Artigos e Materiais de Revistas Científicas - LIM/33
Artigos e Materiais de Revistas Científicas - ODS/03