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Clinical science
The United Kingdom Diabetic Retinopathy Electronic Medical Record Users Group, Report 1: baseline characteristics and visual acuity outcomes in eyes treated with intravitreal injections of ranibizumab for diabetic macular oedema
  1. Catherine Egan1,2,
  2. Haogang Zhu3,
  3. Aaron Lee4,
  4. Dawn Sim5,6,
  5. Danny Mitry1,
  6. Clare Bailey7,
  7. Robert Johnston8,
  8. Usha Chakravarthy9,
  9. Alastair Denniston10,
  10. Adnan Tufail1,2,
  11. Rehna Khan11,
  12. Sajjad Mahmood12,
  13. Geeta Menon13,
  14. Toks Akerele14,
  15. Louise Downey15,
  16. Martin McKibbin16,
  17. Atul Varma17,
  18. Aires Lobo18,
  19. Elizabeth Wilkinson19,
  20. Alan Fitt20,
  21. Christopher Brand21,
  22. Marie Tsaloumas22,
  23. Kaveri Mandal23,
  24. Vineeth Kumar24,
  25. Salim Natha25,
  26. David Crabb26
  27. on behalf of the UK AMD and DR EMR Users Group
    1. 1Department of Medical Retina, Moorfields Eye Hospital NHS Foundation Trust, London, UK
    2. 2Institute of Ophthlamology, London, UK
    3. 3City University, London, London, UK
    4. 4Department of Ophthalmology, University of Washington, Seattle, USA
    5. 5Department of Medical Retina, Moorfields Eye Hospital, London, UK
    6. 6Department of Cell Biology, UCL Institute of Ophthalmology, London, UK
    7. 7Bristol Eye Hospital, Bristol, UK
    8. 8Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
    9. 9Queens University, Belfast, UK
    10. 10University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
    11. 11Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, UK
    12. 12Manchester Royal Eye Hospital, Manchester, UK
    13. 13Eye Department, Frimley Park Hospital, Frimley, UK
    14. 14Hinchingbrooke Health Care NHS Trust, Huntingdon, Cambridgeshire, UK
    15. 15Department of Ophthalmology, Hull Royal Infirmary, Hull, UK
    16. 16Leeds, UK
    17. 17Mid Yorkshire Hospitals NHS Trust, Yorkshire, UK
    18. 18Moorfields Eye Hospital NHS Foundation Trust, London, London, UK
    19. 19Northern Devon Healthcare NHS Trust, Barnstaple, Devon, UK
    20. 20Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, Peterborough, UK
    21. 21Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
    22. 22Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
    23. 23Department of Ophthalmology, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, UK
    24. 24Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
    25. 25Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
    26. 26Division of Optometry & Visual Science, City University, London, UK
    1. Correspondence to Catherine Egan, Department of Medical Retina, Moorfields Eye Hospital NHS Trust, 162 City Road, London EC1V 2PD, UK; catherine.egan{at}moorfields.nhs.uk

    Abstract

    Aims To describe baseline characteristics and visual outcome for eyes treated with ranibizumab for diabetic macular oedema (DMO) from a multicentre database.

    Methods Structured clinical data were anonymised and extracted from an electronic medical record from 19 participating UK centres: age at first injection, ETDRS visual acuity (VA), number of injections, ETDRS diabetic retinopathy (DR) and maculopathy grade at baseline and visits. The main outcomes were change in mean VA from baseline, number of injections and clinic visits and characteristics affecting VA change and DR grade.

    Results Data from 12 989 clinic visits was collated from baseline and follow-up for 3103 eyes. Mean age at first treatment was 66 years. Mean VA (letters) for eyes followed at least 2 years was 51.1 (SD=19.3) at baseline, 54.2 (SD: 18.6) and 52.5 (SD: 19.4) at 1 and 2 years, respectively. Mean visual gain was five letters. The proportion of eyes with VA of 72 letters or better was 25% (baseline) and 33% (1 year) for treatment naïve eyes. Eyes followed for at least 6 months received a mean of 3.3 injections over a mean of 6.9 outpatient visits in 1 year.

    Conclusions In a large cohort of eyes with DMO treated with ranibizumab injections in the UK, 33% of patients achieved better than or equal to 6/12 in the treated eye at 12 months compared with 25% at baseline. The mean visual gain was five letters. Eyes with excellent VA at baseline maintain good vision at 18 months.

    • Retina
    • Macula
    • Treatment Medical
    • Treatment Surgery
    • Public health

    https://doi.org/10.1136/bjophthalmol-2016-309313

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      Footnotes

      • Twitter Follow David Crabb @crabblab

      • Collaborators UK AMD and DR EMR Users Group: Contributing Centres and Lead Clinician at each centre: Belfast Health and Social Care Trust, Professor Usha Chakravarthy; Calderdale and Huddersfield NHS Foundation Trust, Mrs Rehna Khan; Cambridge University Hospitals NHS Foundation Trust, Mr Jong Min Ong; Central Manchester University Hospitals NHS Foundation Trust, Mr Sajjad Mahmood; Frimley Park Hospital NHS Foundation Trust, Mrs Geeta Menon; Gloucestershire Hospitals NHS Foundation Trust, Mr Robert Johnston; Heart of England NHS Foundation Trust, Miss Saher Al-Husainy; Hinchingbrooke Health Care NHS Trust, Ms Toks Akerele; Hull and East Yorkshire Hospitals NHS Foundation Trust, Miss Louise Downey; Leeds Teaching Hospitals NHS Trust, Mr Martin McKibbin; Mid Yorkshire Hospitals NHS Trust, Mr Atul Varma; Moorfields Eye Hospital at Bedford Hospital, Mr Aires Lobo; Northern Devon Healthcare NHS Trust, Dr Elizabeth Wilkinson; Peterborough and Stamford Hospitals NHS Foundation Trust, Mr Alan Fitt; Sheffield Teaching Hospitals NHS Foundation Trust, Mr Christopher Brand; University Hospitals Birmingham NHS Foundation Trust, Miss Marie Tsaloumas; University Hospitals Bristol NHS Foundation Trust, Miss Clare Bailey; Warrington and Halton Hospitals NHS Foundation Trust, Miss Kaveri Mandal; Wirral University Teaching Hospital NHS Foundation Trust, Mr Vineeth Kumar; Wrightington, Wigan and Leigh NHS Foundation Trust, Mr Salim Natha.

      • Contributors All the authors have contributed to the planning, conduct and reporting of the work described in the article.

      • Funding This work was supported in part by an unrestricted research award by Novartis Pharmaceuticals. This research has received a proportion of its funding from the Department of Health's NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology.

      • Competing interests RJ is the Medical Director of Medisoft, the Electronic Medical Record software provider from which data were extracted.

      • Provenance and peer review Not commissioned; externally peer reviewed.

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